0001042167-15-000153.txt : 20151001 0001042167-15-000153.hdr.sgml : 20151001 20151001164617 ACCESSION NUMBER: 0001042167-15-000153 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20151001 FILED AS OF DATE: 20151001 DATE AS OF CHANGE: 20151001 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Citizens Community Bancorp Inc. CENTRAL INDEX KEY: 0001367859 STANDARD INDUSTRIAL CLASSIFICATION: SAVINGS INSTITUTION, FEDERALLY CHARTERED [6035] IRS NUMBER: 000000000 STATE OF INCORPORATION: MD FISCAL YEAR END: 0930 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 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Schaefer Edward H CENTRAL INDEX KEY: 0001480691 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33003 FILM NUMBER: 151137504 MAIL ADDRESS: STREET 1: C/O CITIZENS COMMUNITY BANCORP, INC. STREET 2: 2174 EASTRIDGE CENTER CITY: EAU CLAIRE STATE: WI ZIP: 54701 4 1 primary_doc.xml PRIMARY DOCUMENT X0306 4 2015-10-01 0 0001367859 Citizens Community Bancorp Inc. CZWI 0001480691 Schaefer Edward H C/O CITIZENS COMMUNITY BANCORP, INC. 2174 EASTRIDGE CENTER EAU CLAIRE WI 54701 0 1 0 0 Chief Exec. Officer/President Common Stock, par value $.01 per share 2015-10-01 4 F 0 657 8.84 D 74994 D The reporting person surrendered 657 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 2004 Recognition and Retention Plan. /s/ Edward Schaefer 2015-10-01