0001209191-22-002558.txt : 20220107 0001209191-22-002558.hdr.sgml : 20220107 20220107183814 ACCESSION NUMBER: 0001209191-22-002558 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220104 FILED AS OF DATE: 20220107 DATE AS OF CHANGE: 20220107 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Waltz-Jaskolski Donna M. CENTRAL INDEX KEY: 0001718888 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36192 FILM NUMBER: 22519261 MAIL ADDRESS: STREET 1: 100 TIA TRAIL CITY: LOWELL STATE: MI ZIP: 49331 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 2022-01-04 0 0000944745 CIVISTA BANCSHARES, INC. CIVB 0001718888 Waltz-Jaskolski Donna M. 1730 SANDPIPER COURT HURON OH 44839 0 1 0 0 Senior Vice President Common 2022-01-04 4 F 0 281 24.66 D 2038 D /s/Amy L. Grant by Power of Attorney 2022-01-07