0001209191-11-048326.txt : 20110919 0001209191-11-048326.hdr.sgml : 20110919 20110919153713 ACCESSION NUMBER: 0001209191-11-048326 CONFORMED SUBMISSION TYPE: 3/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20110503 FILED AS OF DATE: 20110919 DATE AS OF CHANGE: 20110919 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Close Michael J CENTRAL INDEX KEY: 0001519755 FILING VALUES: FORM TYPE: 3/A SEC ACT: 1934 Act SEC FILE NUMBER: 000-25980 FILM NUMBER: 111097275 MAIL ADDRESS: STREET 1: 4951 WINDSOR PARK CITY: SARASOTA STATE: FL ZIP: 34235 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 3/A 1 doc3a.xml FORM 3/A SUBMISSION X0204 3/A 2011-05-03 2011-05-03 0 0000944745 FIRST CITIZENS BANC CORP /OH FCZA 0001519755 Close Michael J 4951 WINDSOR PARK SARASOTA FL 34235 1 0 0 0 Common 5200 I Adult daughter's account - spouse is Trustee Common 28611 D Common 12297 D Common 3400 I Spouse Common 72240 I Mary Lee G Close Trust Common 49083 I Mary Lee G Close Des Trust Common 11450 I NLS Asset Management Corp Defined Benefit Plan Common 7000 I NLS Asset Management Corp 401K We were not aware at the time of initial filing that Nancy Close was a Trustee on this account. This 3A is being done to amend this initial filing to add this account. 9/19/2011 Michael J Close 2011-09-19