0001209191-12-046276.txt : 20120920 0001209191-12-046276.hdr.sgml : 20120920 20120920115426 ACCESSION NUMBER: 0001209191-12-046276 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20120920 FILED AS OF DATE: 20120920 DATE AS OF CHANGE: 20120920 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: NICKLES ALLEN R CENTRAL INDEX KEY: 0001265669 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-25980 FILM NUMBER: 121101388 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 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2012-09-20 0 0000944745 FIRST CITIZENS BANC CORP /OH FCZA 0001265669 NICKLES ALLEN R 3308 E BEVERLY DRIVE SANDUSKY OH 44870 1 0 0 0 Common 2012-09-20 4 P 0 137 5.21 A 60200 I SEP IRA Common 1400 I Benefit IRA Common 1100 I Spouse Common 725 I Daughter /s/Allen R Nickles 2012-09-20