0001209191-16-115470.txt : 20160425
0001209191-16-115470.hdr.sgml : 20160425
20160425145058
ACCESSION NUMBER: 0001209191-16-115470
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20160425
FILED AS OF DATE: 20160425
DATE AS OF CHANGE: 20160425
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: MILLER JAMES O
CENTRAL INDEX KEY: 0001193441
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36192
FILM NUMBER: 161588763
MAIL ADDRESS:
STREET 1: 100 EAST WATER STREET
CITY: SANDUSKY
STATE: OH
ZIP: 44870
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2016-04-25
0
0000944745
CIVISTA BANCSHARES, INC.
CIVB
0001193441
MILLER JAMES O
3922 DEERPATH DRIVE
SANDUSKY
OH
44870
1
1
0
0
President and CEO
Common
2016-04-25
4
A
0
3520
0.00
A
6959
D
Common
4240
I
IRA
Common
3800
I
Spouse IRA
Common
240
I
Daughter #1
Common
240
I
Daughter #2
Common
2000
D
Depositary Shares
600
I
FBO MARTHA M MILLER IRA 900183013
Depositary Shares
1400
D
Restricted shares granted from First Citizens Banc Corp's 2014 Incentive Plan are subject to time-based vesting.
/s/James O Miller
2016-04-25