0001209191-13-018164.txt : 20130325 0001209191-13-018164.hdr.sgml : 20130325 20130325133109 ACCESSION NUMBER: 0001209191-13-018164 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20131231 FILED AS OF DATE: 20130325 DATE AS OF CHANGE: 20130325 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Close Michael J CENTRAL INDEX KEY: 0001519755 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-25980 FILM NUMBER: 13713570 MAIL ADDRESS: STREET 1: 4951 WINDSOR PARK CITY: SARASOTA STATE: FL ZIP: 34235 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 2013-12-31 1 0 0 0000944745 FIRST CITIZENS BANC CORP /OH FCZA 0001519755 Close Michael J 4951 WINDSOR PARK SARASOTA FL 34235 1 0 0 0 Common 3498 I Daughter Common 37075 I NLS Asset Management Corp Dbp Common 50714 D Common 3800 I Spouse Common 72240 I Mother's Trust Common 49083 I Mother's DEC Trust Common 7000 I NLS Asset Mgmt Corp 401K Common 6200 I Adult Daughter's Account - Spouse Trustee Preferred 570 D Mr. Close is no longer an Insider. He passed away on February 7, 2012. /s/Michael J Close 2013-03-25