0001437749-16-043621.txt : 20161221 0001437749-16-043621.hdr.sgml : 20161221 20161221111757 ACCESSION NUMBER: 0001437749-16-043621 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20161219 FILED AS OF DATE: 20161221 DATE AS OF CHANGE: 20161221 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: CITIZENS & NORTHERN CORP CENTRAL INDEX KEY: 0000810958 STANDARD INDUSTRIAL CLASSIFICATION: STATE COMMERCIAL BANKS [6022] IRS NUMBER: 232451943 STATE OF INCORPORATION: PA FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 90-92 MAIN ST CITY: WELLSBORO STATE: PA ZIP: 16901 BUSINESS PHONE: 877-838-2517 MAIL ADDRESS: STREET 1: 90-92 MAIN ST CITY: WELLSBORO STATE: PA ZIP: 16901 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: D'Haene Shelley L CENTRAL INDEX KEY: 0001565902 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-16084 FILM NUMBER: 162063103 MAIL ADDRESS: STREET 1: 471 BAILEY RD CITY: LAWRENCEVILLE STATE: RI ZIP: 16901 4 1 rdgdoc.xml FORM 4 X0306 4 2016-12-19 0000810958 CITIZENS & NORTHERN CORP CZNC 0001565902 D'Haene Shelley L 471 BAILEY ROAD LAWRENCEVILLE PA 16929 1 EVP Common Stock 2016-12-19 4 M 0 420 22.325 A 4777 D Common Stock 2016-12-19 4 M 0 745 17.50 A 5522 D Common Stock 2016-12-19 4 F 0 874 25.635 D 4648 D Common Stock 3175 I By ESOP Director Stock Options 22.325 2016-12-19 4 M 0 420 0 D 2007-07-03 2017-01-03 Common Stock 420 0 D Director Stock Options 17.50 2016-12-19 4 M 0 745 0 D 2008-07-03 2018-01-03 Common Stock 745 0 D Payment of Exercise Price by delivering securities incident to the exercise of a vested option in accordance with Rule 16b-3 /s/ Teri L. Mitchell POA for Shelley D'Haene 1/2/13 2016-12-21