0001367859-24-000028.txt : 20240129
0001367859-24-000028.hdr.sgml : 20240129
20240129160209
ACCESSION NUMBER: 0001367859-24-000028
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: SKARVAN KATHLEEN
CENTRAL INDEX KEY: 0001266296
ORGANIZATION NAME:
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-33003
FILM NUMBER: 24573581
MAIL ADDRESS:
STREET 1: 40 WEST HIGHLAND PARK DR NE
CITY: HUTCHINSON
STATE: MN
ZIP: 55350
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_1706562114.xml
FORM 4
X0508
4
2024-01-25
0
0001367859
Citizens Community Bancorp Inc.
CZWI
0001266296
SKARVAN KATHLEEN
C/O CITIZENS COMMUNITY BANCORP, INC.
2174 EASTRIDGE CENTER
EAU CLAIRE
WI
54701
1
0
0
0
0
Common Stock, par value $0.01 per share
2024-01-25
4
A
0
1893
11.88
A
8601
D
Common Stock, par value $.01 per share
300
I
By PK Skarvan Trust
Represents restricted shares of Common Stock awarded under the Company's 2018 Equity Incentive Plan, which shares vest December 31, 2024.
These shares are held by the PK Skarvan Trust pursuant to which Kathleen Skarvan and Paul Skarvan are trustees.
/s/ Rebecca L. Johnson, Attorney-in-fact
2024-01-29