0001209191-13-009373.txt : 20130219
0001209191-13-009373.hdr.sgml : 20130219
20130215160248
ACCESSION NUMBER: 0001209191-13-009373
CONFORMED SUBMISSION TYPE: 5
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20121231
FILED AS OF DATE: 20130215
DATE AS OF CHANGE: 20130215
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: NICKLES ALLEN R
CENTRAL INDEX KEY: 0001265669
FILING VALUES:
FORM TYPE: 5
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-25980
FILM NUMBER: 13619707
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
0
0
0
0000944745
FIRST CITIZENS BANC CORP /OH
FCZA
0001265669
NICKLES ALLEN R
3308 E BEVERLY DRIVE
SANDUSKY
OH
44870
1
0
0
0
Common
2012-12-31
5
Z
0
200
D
1200
I
Benefit IRA
Common
2012-12-31
5
Z
0
200
A
1300
I
Spouse
Common
725
I
Daughter
Common
68700
I
SEP IRA
200 shares transferred to Diane Nickles (Spouse) from Allen R Nickles Benefit IRA
/s/Allen R Nickles
2013-02-15