0001209191-16-150003.txt : 20161115 0001209191-16-150003.hdr.sgml : 20161115 20161115092651 ACCESSION NUMBER: 0001209191-16-150003 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20161114 FILED AS OF DATE: 20161115 DATE AS OF CHANGE: 20161115 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: NICKLES ALLEN R CENTRAL INDEX KEY: 0001265669 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36192 FILM NUMBER: 161997998 MAIL ADDRESS: STREET 1: 100 EAST WATER STREET CITY: SANDUSKY STATE: OH ZIP: 44870 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2016-11-14 0 0000944745 CIVISTA BANCSHARES, INC. CIVB 0001265669 NICKLES ALLEN R 3308 E BEVERLY DRIVE SANDUSKY OH 44870 1 0 0 0 Common 2016-11-14 4 P 0 300 15.00 A 102245 I SEP IRA Common 895 I Benefit IRA Common 1605 I Spouse Common 725 I Daughter Common 1155 D Depositary Shares 3200 D /s/Allen R Nickles 2016-11-15