0001209191-21-007734.txt : 20210204 0001209191-21-007734.hdr.sgml : 20210204 20210204163007 ACCESSION NUMBER: 0001209191-21-007734 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20201231 FILED AS OF DATE: 20210204 DATE AS OF CHANGE: 20210204 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: WURM GERALD B CENTRAL INDEX KEY: 0001193469 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36192 FILM NUMBER: 21591553 MAIL ADDRESS: STREET 1: 100 EAST WATER STREET CITY: SANDUSKY STATE: OH ZIP: 44870 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 2020-12-31 0 0 0 0000944745 CIVISTA BANCSHARES, INC. CIVB 0001193469 WURM GERALD B 4905 ALBAUGH ROAD NEW WASHINGTON OH 44854 0 0 0 1 Subsidiary Director Common 2020-08-01 5 J 0 299.466 0.00 A 36534.587 I Trust Common 2020-11-02 5 J 0 14.528 0.00 A 36549.115 I Trust Common 1275 I Grandson #1 Trust Common 51461 I Trust Common 32253 I Mary L. Wurm Trust Common shares acquired by company dividend reinvestment feature. /s/ Amy L. Grant, by Power of Attorney 2021-02-04