<SEC-DOCUMENT>0001209191-21-007156-index.html : 20210203 <SEC-HEADER>0001209191-21-007156.hdr.sgml : 20210203 <ACCEPTANCE-DATETIME>20210203150559 ACCESSION NUMBER: 0001209191-21-007156 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20201231 FILED AS OF DATE: 20210203 DATE AS OF CHANGE: 20210203 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Betts John A CENTRAL INDEX KEY: 0001566871 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36192 FILM NUMBER: 21585881 MAIL ADDRESS: STREET 1: 7 OAKFIELD DRIVE CITY: MILAN STATE: OH ZIP: 44846 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 </SEC-HEADER> <DOCUMENT> <TYPE>5 <SEQUENCE>1 <FILENAME>doc5.xml <DESCRIPTION>FORM 5 SUBMISSION <TEXT> Document 1 - file: doc5.html
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