0001209191-11-048371.txt : 20110919 0001209191-11-048371.hdr.sgml : 20110919 20110919163802 ACCESSION NUMBER: 0001209191-11-048371 CONFORMED SUBMISSION TYPE: 4/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: 4/A SEC ACT: 1934 Act SEC FILE NUMBER: 000-25980 FILM NUMBER: 111097639 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 4/A 1 doc4a.xml FORM 4/A SUBMISSION X0304 4/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 34917 D Common 12297 D Common 3800 I Spouse Common 72240 I Mary Lee G Close Trust Common 49083 I Mary Lee G Close Dec Trust Common 16475 I NLS Asset Mgmt Corp Defined Plan Common 7000 I NLS Asset Mgmt Corp 401K We were not aware at initial filing that Nancy Close (spouse) was a Trustee on this account. This 4A was done to bring accounts up to date. A form 3A was also filed on this date to bring initial filing up to date. /s/Michael J Close 2011-09-19