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