0001209191-19-059975.txt : 20191211
0001209191-19-059975.hdr.sgml : 20191211
20191211101307
ACCESSION NUMBER: 0001209191-19-059975
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20191210
FILED AS OF DATE: 20191211
DATE AS OF CHANGE: 20191211
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: FRIEDLEY BLYTHE A
CENTRAL INDEX KEY: 0001078308
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36192
FILM NUMBER: 191279118
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
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2019-12-10
0
0000944745
CIVISTA BANCSHARES, INC.
CIVBP
0001078308
FRIEDLEY BLYTHE A
423 WEST MAIN STREET
NEW WASHINGTON
OH
44854
0
0
0
1
Subsidiary Director
Common
2019-12-10
4
J
0
555
0.00
D
11194
I
Trusteee on Arlene M. Friedley CRUT Trust
Common
2019-12-10
4
J
0
555
0.00
A
59667
I
Trust
Common
2019-12-10
4
C
0
639
7.82
A
11662
I
Trusts
Depositary Shares
2019-12-10
4
C
0
200
7.82
D
0
I
BLYTHE A FRIEDLEY TRUST UAD 2/23/99
Common
4766
I
TTEE on Arlene M. Friedley Trust
Common
2878
D
Transferred shares from CRUT account to Trust account.
The reporting person exercised her right to convert depositary shares into common shares(based on a conversion ratio of 3.196931 common shares for each depositary share)effective December 10, 2019. Each depositary share represented 1/40th interest in a share of the Company's 6.50% Series B Preferred Shares and was convertible into common shares at any time.
/s/Amy L. Grant, by Power of Attorney
2019-12-11