-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, OodfclkF/9DmWCJKa616En51YUY/WGT/2y4q0C8x1v8c9d5ld+OPXh8vXeYyi549 x5LII85yJyGmzutPLvcL7g== 0001209191-05-025832.txt : 20050513 0001209191-05-025832.hdr.sgml : 20050513 20050513152617 ACCESSION NUMBER: 0001209191-05-025832 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20050421 FILED AS OF DATE: 20050513 DATE AS OF CHANGE: 20050513 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SHEAFFER WILLIAM G CENTRAL INDEX KEY: 0001193457 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-25980 FILM NUMBER: 05828850 MAIL ADDRESS: STREET 1: 100 EAST WATER STREET CITY: SANDUSKY STATE: OH ZIP: 44870 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: FIRST CITIZENS BANC CORP /OH CENTRAL INDEX KEY: 0000944745 STANDARD INDUSTRIAL CLASSIFICATION: STATE COMMERCIAL BANKS [6022] IRS NUMBER: 341558688 STATE OF INCORPORATION: OH FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 100 EAST WATER ST STREET 2: P O BOX 5016 CITY: SANDUSKY STATE: OH ZIP: 44870 BUSINESS PHONE: 4196254121 MAIL ADDRESS: STREET 1: 100 EAST WATER ST STREET 2: P O BOX 5016 CITY: SANDUSKY STATE: OH ZIP: 44870 5 1 bcl14017_bcl1.xml MAIN DOCUMENT DESCRIPTION X0202 5 2005-04-21 1 1 0 0000944745 FIRST CITIZENS BANC CORP /OH FCZA 0001193457 SHEAFFER WILLIAM G PO BOX 112 6768 BAKER ROAD TIRO OH 44887 0 0 0 1 Affiliate Director Common 3 1200 D Retired as Affiliate Director as of April 21, 2005 /s/ William G Sheaffer 2005-05-13 -----END PRIVACY-ENHANCED MESSAGE-----