0001209191-12-038437.txt : 20120718 0001209191-12-038437.hdr.sgml : 20120718 20120718123520 ACCESSION NUMBER: 0001209191-12-038437 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20121231 FILED AS OF DATE: 20120718 DATE AS OF CHANGE: 20120718 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BETTCHER LAURENCE A CENTRAL INDEX KEY: 0001193413 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-25980 FILM NUMBER: 12967366 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 X0306 5 2012-12-31 1 0 0 0000944745 FIRST CITIZENS BANC CORP /OH FCZA 0001193413 BETTCHER LAURENCE A 415 NEWPORT DR HURON OH 44839 1 0 0 0 Common 14600 D Common 950 D Common 799 I Spouse This filing is to remove Laurence A Bettcher from First Citizens Banc Corp (FCZA) Insider list. He is no longer a director. /s/Laurence A Bettcher 2012-07-18