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