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