0001209191-11-063031.txt : 20111223 0001209191-11-063031.hdr.sgml : 20111223 20111223165016 ACCESSION NUMBER: 0001209191-11-063031 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20111222 FILED AS OF DATE: 20111223 DATE AS OF CHANGE: 20111223 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Close Michael J CENTRAL INDEX KEY: 0001519755 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-25980 FILM NUMBER: 111280696 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 1 doc4.xml FORM 4 SUBMISSION X0304 4 2011-12-22 0 0000944745 FIRST CITIZENS BANC CORP /OH FCZA 0001519755 Close Michael J 4951 WINDSOR PARK SARASOTA FL 34235 1 0 0 0 Common 2011-12-22 4 P 0 3 3.70 A 29658 I NLS Asset Mgmt Corp Defined Plan Common 2011-12-22 4 P 0 567 3.67 A 30225 I NLS Asset Mgmt Corp Defined Plan 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 7000 I NLS Asset Management Corp 401K Common 5200 I Adult daughter's acct - spouse is trustee /s/Michael J Close 2011-12-23