0001367859-22-000039.txt : 20220131
0001367859-22-000039.hdr.sgml : 20220131
20220131092846
ACCESSION NUMBER: 0001367859-22-000039
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: MCHUGH RICHARD
CENTRAL INDEX KEY: 0001279160
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-33003
FILM NUMBER: 22571606
MAIL ADDRESS:
STREET 1: C/O CITIZENS COMMUNITY BANCORP
STREET 2: 2174 EASTRIDGE CENTER
CITY: EAU CLAIRE
STATE: WI
ZIP: 54701
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_164363931384869.xml
FORM 4
X0306
4
2022-01-27
0
0001367859
Citizens Community Bancorp Inc.
CZWI
0001279160
MCHUGH RICHARD
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
2142
14
A
188887
D
Common Stock, par value $0.01 per share
34596
I
By Spouse
Represents restricted shares of Common Stock awarded under the Company's 2018 Equity Incentive Plan, which shares vest December 31, 2022.
The shares purchased included 141 shares purchased by the reporting person's spouse directly and 41 shares purchased by the reporting person's spouse as custodian for the benefit of her grandchildren. Following such acquisitions, the reporting person's spouse owns 34,275 shares of our common stock directly and 321 shares are held by the reporting person's spouse as custodian for her grandchildren. Mr. McHugh disclaims beneficial ownership of these shares except to the extent of his pecuniary interest therein.
/s/ Rebecca L. Johnson, Attorney-in-fact
2022-01-31