0001209191-15-011902.txt : 20150211 0001209191-15-011902.hdr.sgml : 20150211 20150211150016 ACCESSION NUMBER: 0001209191-15-011902 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20141231 FILED AS OF DATE: 20150211 DATE AS OF CHANGE: 20150211 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 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: WURM GERALD B CENTRAL INDEX KEY: 0001193469 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36192 FILM NUMBER: 15599068 MAIL ADDRESS: STREET 1: 100 EAST WATER STREET CITY: SANDUSKY STATE: OH ZIP: 44870 5 1 doc5.xml FORM 5 SUBMISSION X0306 5 2014-12-31 0 0 0 0000944745 FIRST CITIZENS BANC CORP /OH FCZA 0001193469 WURM GERALD B 4905 ALBAUGH ROAD NEW WASHINGTON OH 44854 0 0 0 1 Subsidiary Director Common 2014-12-31 5 J 0 564 0.00 D 0 I Joint w/spouse - daughter #2's Trust Common 2014-12-31 5 J 0 60.6475 0.00 A 2885.324 I Trust Common 2014-12-31 5 J 0 564 0.00 D 448.4973 I Joint w/spouse - daughter #1's Trust Common 2014-12-31 5 J 0 21.737 0.00 A 470.2343 I Joint w/spouse - daughter #1's Trust Common 2550 I Grandson #1 Trust Common 550 I Grandson #2 Trust Common 46769 I Trust Depositary Shares 9000 I Gerald B Wurm Trust UAD 2/26/99 Common 5000 I Mary L. Wurm Trust End of year - reporting person no longer reports as beneficially owned any securities owned by daughter. End of year - common shares acquired on company dividend reinvestment feature. /s/Gerald B Wurm 2015-02-11