0001367859-21-000140.txt : 20210825 0001367859-21-000140.hdr.sgml : 20210825 20210825164127 ACCESSION NUMBER: 0001367859-21-000140 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210825 FILED AS OF DATE: 20210825 DATE AS OF CHANGE: 20210825 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Bianchi Stephen M CENTRAL INDEX KEY: 0001497054 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33003 FILM NUMBER: 211207413 MAIL ADDRESS: STREET 1: 225 S. MAIN AVENUE CITY: SIOUX FALLS STATE: SD ZIP: 57104 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_162992405805569.xml FORM 4 X0306 4 2021-08-25 0 0001367859 Citizens Community Bancorp Inc. CZWI 0001497054 Bianchi Stephen M C/O CITIZENS COMMUNITY BANCORP, INC. 2174 EASTRIDGE CENTER EAU CLAIRE WI 54701 1 1 0 0 CEO and President Common Stock, par value $0.01 per share 2021-08-25 4 P 0 200 13.96 A 47741 I By IRA Common Stock, par value $0.01 per share 2021-08-25 4 P 0 200 13.95 A 47941 I By IRA Common Stock, par value $0.01 per share 50768 D Common Stock Option (right to buy) 11.0 2026-06-24 Common Stock 20000.0 20000 D These shares are held in the reporting person's self-directed IRA. 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 24, 2017, June 24, 2018, June 24, 2019, June 24, 2020 and June 24, 2021. /s/ Rebecca L. Johnson, Attorney-in-fact 2021-08-25