-----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, CptHCTkwKJxRtCRBben19OQ7uiY9bZOaMf3JSlMFDwMhjPDidQNAeOXE81OBdT9q 12RYulgA0zoLA89YVVBDMA== 0001209191-05-052539.txt : 20051017 0001209191-05-052539.hdr.sgml : 20051017 20051017130314 ACCESSION NUMBER: 0001209191-05-052539 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20051017 FILED AS OF DATE: 20051017 DATE AS OF CHANGE: 20051017 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Gates Douglas J CENTRAL INDEX KEY: 0001308959 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-25980 FILM NUMBER: 051140524 BUSINESS ADDRESS: BUSINESS PHONE: 419-625-4121 MAIL ADDRESS: STREET 1: 100 E 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 bcl16431_bcl1djg.xml MAIN DOCUMENT DESCRIPTION X0202 5 2005-10-17 1 0 0 0000944745 FIRST CITIZENS BANC CORP /OH FCZA 0001308959 Gates Douglas J 15 ROSEDALE BLVD NORWALK OH 44857 0 1 0 0 Sr. Vice President Common 4722 D Common 950 D Common 604.252 I Spouse Common 400.5971 I Son As the result of a merger, Mr. Gates is no longer an Insider of FCBC /s/ Douglas J Gates 2005-10-17 -----END PRIVACY-ENHANCED MESSAGE-----