0001209191-13-009493.txt : 20130219 0001209191-13-009493.hdr.sgml : 20130219 20130219084543 ACCESSION NUMBER: 0001209191-13-009493 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20121231 FILED AS OF DATE: 20130219 DATE AS OF CHANGE: 20130219 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: HECKELMAN JAMES D CENTRAL INDEX KEY: 0001193427 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-25980 FILM NUMBER: 13621609 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 0001193427 HECKELMAN JAMES D 4694 OLD STATE ROAD NORWALK OH 44857 1 0 0 0 Common 2012-12-27 5 Z 0 795 A 9517 D Common 2012-12-27 5 Z 0 796 A 9518 I Spouse Common 2012-12-31 5 J 0 53.747 A 2618.482 I IRA Common 2012-12-31 5 J 0 53.747 A 2618.482 I Spouse IRA Shares transferred from James D Heckelman & Margaret F Heckelman JT TEN account Catch up filing of DRIP shares acquired as of 12/31/2012 /s/James D Heckelman 2013-02-19