0001552781-21-000367.txt : 20210506 0001552781-21-000367.hdr.sgml : 20210506 20210506172202 ACCESSION NUMBER: 0001552781-21-000367 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210504 FILED AS OF DATE: 20210506 DATE AS OF CHANGE: 20210506 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Nickum David Frank CENTRAL INDEX KEY: 0001857891 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40379 FILM NUMBER: 21899027 MAIL ADDRESS: STREET 1: 3100 ZINFANDEL DRIVE, SUITE 100 CITY: RANCHO CORDOVA STATE: CA ZIP: 95670 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: FIVE STAR BANCORP CENTRAL INDEX KEY: 0001275168 STANDARD INDUSTRIAL CLASSIFICATION: STATE COMMERCIAL BANKS [6022] IRS NUMBER: 753100966 FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 3100 ZINFANDEL DRIVE STREET 2: SUITE 100 CITY: RANCHO CORDOVA STATE: CA ZIP: 95670 BUSINESS PHONE: 916-626-5000 MAIL ADDRESS: STREET 1: 3100 ZINFANDEL DRIVE STREET 2: SUITE 100 CITY: RANCHO CORDOVA STATE: CA ZIP: 95670 4 1 ownership.xml X0306 4 2021-05-04 0 0001275168 FIVE STAR BANCORP FSBC 0001857891 Nickum David Frank C/O FIVE STAR BANCORP 3100 ZINFANDEL DRIVE, SUITE 100 RANCHO CORDOVA CA 95670 1 0 0 0 Common Stock 2021-05-04 4 P 0 22178 20 A 169006 I By self as trustee Shares are held by the Nickum Family Trust dated March 14, 2008, for which Mr. Nickum serves as a trustee. /s/ David F. Nickum, by Heather C. Luck, Attorney-in-Fact 2021-05-06