0001209191-21-061862.txt : 20211028 0001209191-21-061862.hdr.sgml : 20211028 20211028105012 ACCESSION NUMBER: 0001209191-21-061862 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211022 FILED AS OF DATE: 20211028 DATE AS OF CHANGE: 20211028 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Betts John A CENTRAL INDEX KEY: 0001566871 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36192 FILM NUMBER: 211355863 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 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2021-10-22 1 0000944745 CIVISTA BANCSHARES, INC. CIVB 0001566871 Betts John A 7 OAKFIELD DRIVE MILAN OH 44846 0 1 0 0 Senior Vice President Common 2021-05-01 4 J 0 11.531 0.00 A 4488.52 D Common 2021-08-02 4 J 0 13.752 0.00 A 4502.272 D Common 2021-10-22 4 D 0 2231 0.00 D 2271.272 D Common 1488 D Common 2562 I IRA Common shares acquired by company dividend reinvestment feature. Reflects restricted common shares forfeited to the issuer upon termination of employment. /s/Amy L. Grant, by Power of Attorney 2021-10-28