0001367859-24-000033.txt : 20240129 0001367859-24-000033.hdr.sgml : 20240129 20240129160531 ACCESSION NUMBER: 0001367859-24-000033 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240125 FILED AS OF DATE: 20240129 DATE AS OF CHANGE: 20240129 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BROUCEK JAMES S CENTRAL INDEX KEY: 0001204872 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33003 FILM NUMBER: 24573644 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Citizens Community Bancorp Inc. CENTRAL INDEX KEY: 0001367859 STANDARD INDUSTRIAL CLASSIFICATION: SAVINGS INSTITUTION, FEDERALLY CHARTERED [6035] ORGANIZATION NAME: 02 Finance IRS NUMBER: 205120010 STATE OF INCORPORATION: MD FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 2174 EASTRIDGE CENTER CITY: EAU CLAIRE STATE: WI ZIP: 54701 BUSINESS PHONE: 715 836 9994 MAIL ADDRESS: STREET 1: 2174 EASTRIDGE CENTER CITY: EAU CLAIRE STATE: WI ZIP: 54701 4 1 wk-form4_1706562313.xml FORM 4 X0508 4 2024-01-25 0 0001367859 Citizens Community Bancorp Inc. CZWI 0001204872 BROUCEK JAMES S C/O CITIZENS COMMUNITY BANCORP, INC. 2174 EASTRIDGE CENTER EAU CLAIRE WI 54701 0 1 0 0 EVP/CFO/Treasurer/Secretary 0 Common Stock, par value $0.01 per share 2024-01-25 4 A 0 1432 11.88 A 20309 D Common Stock, par value $0.01 per share 42324 I By IRA Common Stock Option (right to buy) 13.60 2027-10-31 Common Stock 8000 8000 D Shares earned upon vesting and settlement of Performance Restricted Stock Units ("Performance RSU's") awarded January 28, 2021, upon certification of performance results by the Compensation Committee based on the achievement of certain performance criteria for the year ended December 31, 2023, during a 36 month cumulative performance cycle. These shares are held in the reporting person's self-directed IRA. The common stock option awarded under the Company's 2008 Equity Incentive Plan vests as follows: 20% of the shares vest on each of October 31, 2018, October 31, 2019, October 31, 2020, October 31, 2021 and October 31, 2022. /s/ Rebecca L. Johnson, Attorney-in-fact 2024-01-29