0001209191-17-009417.txt : 20170210 0001209191-17-009417.hdr.sgml : 20170210 20170210132145 ACCESSION NUMBER: 0001209191-17-009417 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20161231 FILED AS OF DATE: 20170210 DATE AS OF CHANGE: 20170210 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: Murray Dennis E Jr CENTRAL INDEX KEY: 0001574584 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36192 FILM NUMBER: 17591713 MAIL ADDRESS: STREET 1: 2035 CEDAR POINT ROAD CITY: SANDUSKY STATE: OH ZIP: 44870 5 1 doc5.xml FORM 5 SUBMISSION X0306 5 2016-12-31 0 0 0 0000944745 CIVISTA BANCSHARES, INC. CIVB 0001574584 Murray Dennis E Jr 2035 CEDAR POINT ROAD SANDUSKY OH 44870 1 0 0 0 Common 2016-12-31 5 J 0 9.634 0.00 A 13016.634 D Common 10019 I IRA Rollover Common 5300 I Spouse End of year - common shares acquired by company dividend reinvestment feature. /s/Dennis E Murray Jr 2017-02-10