0001367859-21-000021.txt : 20210201 0001367859-21-000021.hdr.sgml : 20210201 20210201085140 ACCESSION NUMBER: 0001367859-21-000021 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210128 FILED AS OF DATE: 20210201 DATE AS OF CHANGE: 20210201 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Bourget Kristina M CENTRAL INDEX KEY: 0001736360 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33003 FILM NUMBER: 21574848 MAIL ADDRESS: STREET 1: 1703 PINE PARK DRIVE 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_161218748750644.xml FORM 4 X0306 4 2021-01-28 0 0001367859 Citizens Community Bancorp Inc. CZWI 0001736360 Bourget Kristina M 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 2021-01-28 4 A 0 1762 10.78 A 11115 D Represents restricted shares of Common Stock awarded under the Company's 2018 Equity Incentive Plan, which shares vest December 31, 2021. /s/ Rebecca L. Johnson, Attorney-in-fact 2021-02-01