0001209191-19-008517.txt : 20190208
0001209191-19-008517.hdr.sgml : 20190208
20190208162631
ACCESSION NUMBER: 0001209191-19-008517
CONFORMED SUBMISSION TYPE: 5
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20181231
FILED AS OF DATE: 20190208
DATE AS OF CHANGE: 20190208
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: FRIEDLEY BLYTHE A
CENTRAL INDEX KEY: 0001078308
FILING VALUES:
FORM TYPE: 5
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36192
FILM NUMBER: 19580225
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
5
1
doc5.xml
FORM 5 SUBMISSION
X0306
5
2018-12-31
0
0
0
0000944745
CIVISTA BANCSHARES, INC.
CIVB
0001078308
FRIEDLEY BLYTHE A
423 WEST MAIN STREET
NEW WASHINGTON
OH
44854
0
0
0
1
Subsidiary Director
Common
2018-12-31
5
J
0
850
0.00
D
11749
I
Trusteee on Arlene M. Friedley CRUT Trust
Common
2018-12-31
5
J
0
850
0.00
A
59112
I
Trust
Common
11023
I
Trusts
Common
4766
I
TTEE on Arlene M. Friedley Trust
Common
2239
D
Depositary Shares
200
I
BLYTHE A FRIEDLEY TRUST UAD 2/23/99
Transferred shares from CRUT account to Trust account.
/s/Blythe A Friedley
2019-02-08