0001209191-12-010437.txt : 20120215
0001209191-12-010437.hdr.sgml : 20120215
20120215152854
ACCESSION NUMBER: 0001209191-12-010437
CONFORMED SUBMISSION TYPE: 5
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20111231
FILED AS OF DATE: 20120215
DATE AS OF CHANGE: 20120215
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: WURM GERALD B
CENTRAL INDEX KEY: 0001193469
FILING VALUES:
FORM TYPE: 5
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-25980
FILM NUMBER: 12615835
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
doc5.xml
FORM 5 SUBMISSION
X0304
5
2011-12-31
0
0
0
0000944745
FIRST CITIZENS BANC CORP /OH
FCZA
0001193469
WURM GERALD B
4905 ALBAUGH ROAD
NEW WASHINGTON
OH
44854
1
0
0
0
Common
34569
D
Common
2706.7594
D
Common
970.2278
I
Daughter #1's Trust
Common
564
I
Daughter #2's Trust
Common
550
I
Grandson #1
Common
550
I
Grandson #2
Catch up filing of DRIP shares acquired as of 12/31/2009
/s/Gerald B Wurm
2012-02-15