0001209191-16-121520.txt : 20160519 0001209191-16-121520.hdr.sgml : 20160519 20160519141145 ACCESSION NUMBER: 0001209191-16-121520 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160517 FILED AS OF DATE: 20160519 DATE AS OF CHANGE: 20160519 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: WURM GERALD B CENTRAL INDEX KEY: 0001193469 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36192 FILM NUMBER: 161662716 MAIL ADDRESS: STREET 1: 100 EAST WATER STREET CITY: SANDUSKY STATE: OH ZIP: 44870 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2016-05-17 0 0000944745 CIVISTA BANCSHARES, INC. CIVB 0001193469 WURM GERALD B 4905 ALBAUGH ROAD NEW WASHINGTON OH 44854 0 0 0 1 Subsidiary Director Common 2016-05-19 4 J 0 26.003 0.00 A 2965.72 I Trust Common 2016-05-17 4 A 0 945 0.00 A 1155 D Common 51461 I Trust Common 1275 I Grandson #1 Trust Common 10000 I Mary L. Wurm Trust Depositary Shares 9000 I Gerald B Wurm Trust UAD 2/26/99 Common shares acquired by company dividend reinvestment feature. Stock award granted from First Citizens Banc Corp's 2014 Incentive Plan /s/Gerald B Wurm 2016-05-19