0001209191-21-036439.txt : 20210528 0001209191-21-036439.hdr.sgml : 20210528 20210528104725 ACCESSION NUMBER: 0001209191-21-036439 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210527 FILED AS OF DATE: 20210528 DATE AS OF CHANGE: 20210528 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Depler Thomas A CENTRAL INDEX KEY: 0001308958 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36192 FILM NUMBER: 21977124 MAIL ADDRESS: STREET 1: 100 E 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 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2021-05-27 0 0000944745 CIVISTA BANCSHARES, INC. CIVB 0001308958 Depler Thomas A 61 EDGEWATER DR SHELBY OH 44875 1 0 0 0 Common 2021-05-27 4 A 0 628 0.00 A 628 D Common 9168 I Co-trusteee of brother's trust Common 12689 D Common 7672 I IRA Rollover Stock award granted from Civista Bancshares, Inc. 2014 Incentive Plan /s/Amy L Grant, by Power of Attorney 2021-05-28