0001209191-22-008665.txt : 20220211
0001209191-22-008665.hdr.sgml : 20220211
20220211094447
ACCESSION NUMBER: 0001209191-22-008665
CONFORMED SUBMISSION TYPE: 5
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20211231
FILED AS OF DATE: 20220211
DATE AS OF CHANGE: 20220211
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Depler Thomas A
CENTRAL INDEX KEY: 0001308958
FILING VALUES:
FORM TYPE: 5
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36192
FILM NUMBER: 22617195
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
5
1
doc5.xml
FORM 5 SUBMISSION
X0306
5
2021-12-31
0
0
0
0000944745
CIVISTA BANCSHARES, INC.
CIVB
0001308958
Depler Thomas A
61 EDGEWATER DR
SHELBY
OH
44875
1
0
0
0
Common
2021-06-29
5
J
0
628
0.00
A
13317
D
Common
2021-06-29
5
J
0
628
0.00
D
0
D
Common
9168
I
Co-trusteee of brother's trust
Common
7672
I
IRA Rollover
Shares transferred from another account.
Transferred shares to another account.
/s/Amy L. Grant, by Power of Attorney
2022-02-11