0001209191-17-009430.txt : 20170210 0001209191-17-009430.hdr.sgml : 20170210 20170210135036 ACCESSION NUMBER: 0001209191-17-009430 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: Singer Harry CENTRAL INDEX KEY: 0001605759 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36192 FILM NUMBER: 17591927 MAIL ADDRESS: STREET 1: 5309 GOLFWAY LANE CITY: LYNDHURST STATE: OH ZIP: 44124 5 1 doc5.xml FORM 5 SUBMISSION X0306 5 2016-12-31 0 0 0 0000944745 CIVISTA BANCSHARES, INC. CIVB 0001605759 Singer Harry 5309 GOLFWAY LANE LYNDHURST OH 44124 0 0 0 1 Subsidiary Director Common 2016-12-31 5 J 0 4.709 0.00 A 1665.543 D Common 5800 I President of Sandusco Inc (corporate owner) End of year - common shares acquired by company dividend reinvestment feature. /s/Harry Singer 2017-02-10