0001209191-16-096292.txt : 20160208 0001209191-16-096292.hdr.sgml : 20160208 20160208130534 ACCESSION NUMBER: 0001209191-16-096292 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20151231 FILED AS OF DATE: 20160208 DATE AS OF CHANGE: 20160208 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: CIVISTA BANCSHARES, INC. 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 FORMER COMPANY: FORMER CONFORMED NAME: FIRST CITIZENS BANC CORP /OH DATE OF NAME CHANGE: 19950502 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Boerger Barry W CENTRAL INDEX KEY: 0001421685 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36192 FILM NUMBER: 161394952 MAIL ADDRESS: STREET 1: 12175 URBANNA WOODSTOCK PK CITY: MILFORD CENTER STATE: OH ZIP: 43045 5 1 doc5.xml FORM 5 SUBMISSION X0306 5 2015-12-31 0 0 0 0000944745 CIVISTA BANCSHARES, INC. CIVB 0001421685 Boerger Barry W 4010 HAWK ROAD MECHANICSBURG OH 43044 0 0 0 1 Subsidiary Director Common 2015-12-31 5 J 0 157.208 0.00 A 6683.208 I SEP IRA Common 1774 I Trusts Common 210 D End of year - common shares acquired on company dividend reinvestment feature. /s/Barry W Boerger 2016-02-08