0001209191-17-009424.txt : 20170210
0001209191-17-009424.hdr.sgml : 20170210
20170210134237
ACCESSION NUMBER: 0001209191-17-009424
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 Margaret A
CENTRAL INDEX KEY: 0001490056
FILING VALUES:
FORM TYPE: 5
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36192
FILM NUMBER: 17591865
MAIL ADDRESS:
STREET 1: 142 BAYSHORE DRIVE
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
0001490056
Murray Margaret A
142 BAYSHORE DRIVE
SANDUSKY
OH
44870
0
0
0
1
Retired Director
Common
2016-12-31
5
J
0
1569.791
0.00
A
93127.359
D
Common
163988
I
Def Ben Trust
Common
6000
I
M & M 401 K
Depositary Shares
4000
D
Depositary Shares
6000
I
DPM, Defined Benefit FBO Dennis E Murray Sr
End of year - common shares acquired by company dividend reinvestment feature.
/s/Margaret A Murray
2017-02-10