0001437749-19-000390.txt : 20190107 0001437749-19-000390.hdr.sgml : 20190107 20190107090606 ACCESSION NUMBER: 0001437749-19-000390 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190103 FILED AS OF DATE: 20190107 DATE AS OF CHANGE: 20190107 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: 19512361 MAIL ADDRESS: STREET 1: 471 BAILEY RD CITY: LAWRENCEVILLE STATE: RI ZIP: 16901 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 4 1 rdgdoc.xml SHELLEY D'HAENE X0306 4 2019-01-03 0000810958 CITIZENS & NORTHERN CORP CZNC 0001565902 D'Haene Shelley L 471 BAILEY ROAD LAWRENCEVILLE PA 16929 1 EVP Common Stock 2019-01-03 4 J 0 276 25.6601 A 4312 I By ESOP Common Stock 6742 D Exempt acquisition via employer year end contribution to ESOP /s/ Amy B Wherley POA for Shelley L D'Haene, 10/31/17 2019-01-07