0001367859-22-000036.txt : 20220131 0001367859-22-000036.hdr.sgml : 20220131 20220131092758 ACCESSION NUMBER: 0001367859-22-000036 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220127 FILED AS OF DATE: 20220131 DATE AS OF CHANGE: 20220131 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MOLL JAMES D CENTRAL INDEX KEY: 0001235998 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33003 FILM NUMBER: 22571600 MAIL ADDRESS: STREET 1: 400 9TH AVE SW CITY: WELLS STATE: MN ZIP: 56097 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Citizens Community Bancorp Inc. CENTRAL INDEX KEY: 0001367859 STANDARD INDUSTRIAL CLASSIFICATION: SAVINGS INSTITUTION, FEDERALLY CHARTERED [6035] 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 wf-form4_164363926474213.xml FORM 4 X0306 4 2022-01-27 0 0001367859 Citizens Community Bancorp Inc. CZWI 0001235998 MOLL JAMES D C/O CITIZENS COMMUNITY BANCORP, INC. 2174 EASTRIDGE CENTER EAU CLAIRE WI 54701 1 0 0 0 Common Stock, par value $0.01 per share 2022-01-27 4 A 0 1500 14 A 33371 D Common Stock, par value $0.01 per share 10124 I By IRA Represents restricted shares of Common Stock awarded under the Company's 2018 Equity Incentive Plan, which shares vest December 31, 2022. These shares are held in the reporting person's self-directed IRA. /s/ Rebecca L. Johnson, Attorney-in-fact 2022-01-31