0001209191-18-051971.txt : 20180921 0001209191-18-051971.hdr.sgml : 20180921 20180921180321 ACCESSION NUMBER: 0001209191-18-051971 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20180914 FILED AS OF DATE: 20180921 DATE AS OF CHANGE: 20180921 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: McLaughlin W Michael CENTRAL INDEX KEY: 0001351859 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36192 FILM NUMBER: 181082346 MAIL ADDRESS: STREET 1: 18543 RUNNING DEER LANE CITY: LAWRENCEBURG STATE: IN ZIP: 47025 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 3 1 doc3.xml FORM 3 SUBMISSION X0206 3 2018-09-14 0 0000944745 CIVISTA BANCSHARES, INC. CIVB 0001351859 McLaughlin W Michael 18543 RUNNING DEER LANE LAWRENCEBURG IN 47025 0 0 0 1 Senior Vice President Common 12923 D Common 2611 I Spouse IRA Represents number of Civista Bancshares, Inc. shares into which shares of former company were converted upon completion of the merger on September 14, 2018. /s/W Michael McLaughlin 2018-09-21