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