0001209191-12-012360.txt : 20120223 0001209191-12-012360.hdr.sgml : 20120223 20120223115645 ACCESSION NUMBER: 0001209191-12-012360 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20111231 FILED AS OF DATE: 20120223 DATE AS OF CHANGE: 20120223 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: WHITE DANIEL J CENTRAL INDEX KEY: 0001196384 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-25980 FILM NUMBER: 12632736 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 0001196384 WHITE DANIEL J 38 EAGLE CREEK DRIVE NORWALK OH 44857 1 0 0 0 Common 775.3854 D Common 646.8638 D Catch up filing of DRIP shares acquired as of 12/31/2011 /s/Daniel J White 2012-02-23