0001367859-19-000008.txt : 20190122 0001367859-19-000008.hdr.sgml : 20190122 20190122080323 ACCESSION NUMBER: 0001367859-19-000008 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190117 FILED AS OF DATE: 20190122 DATE AS OF CHANGE: 20190122 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: JOHNSON REBECCA CENTRAL INDEX KEY: 0001279169 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33003 FILM NUMBER: 19534313 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 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_154816218452703.xml FORM 4 X0306 4 2019-01-17 0 0001367859 Citizens Community Bancorp Inc. CZWI 0001279169 JOHNSON REBECCA C/O CITIZENS COMMUNITY BANCORP, INC. 2174 EASTRIDGE CENTER EAU CLAIRE WI 54701 0 1 0 0 Vice President/Controller Common Stock, par value $0.01 per share 2019-01-17 4 F 0 78 11.32 D 3668 D Common Stock, par value $0.01 per share 12841 I By 401(k) Plan Common Stock Option (right to buy) 9.62 2026-06-14 Common Stock 2000.0 2000 D The reporting person surrendered a total of 78 shares of the Company's common stock to satisfy the withholding taxes due upon the vesting of certain previously awarded shares of restricted stock issued under the Company's 2008 Equity Incentive Plan. Represents shares held under the Citizens Community Federal 401(k) Profit Sharing Plan. The common stock option awarded under the Company's 2008 Equity Incentive Plan vests as follows: 20% of the shares vest on each of June 14, 2017, June 14, 2018, June 14, 2019, June 14, 2020 and June 14, 2021. /s/ Rebecca L. Johnson 2019-01-22