0001209191-22-008686.txt : 20220211 0001209191-22-008686.hdr.sgml : 20220211 20220211101022 ACCESSION NUMBER: 0001209191-22-008686 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: FRIEDLEY BLYTHE A CENTRAL INDEX KEY: 0001078308 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36192 FILM NUMBER: 22617386 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 0001078308 FRIEDLEY BLYTHE A 423 WEST MAIN STREET NEW WASHINGTON OH 44854 0 0 0 1 Subsidiary Director Common 2021-12-06 5 J 0 425 0.00 D 9869 I Trusteee on Arlene M. Friedley CRUT Trust Common 2021-12-06 5 J 0 425 0.00 A 60992 I Trust Common 11662 I Trusts Common 4766 I TTEE on Arlene M. Friedley Trust Common 4525 D Transferred shares from CRUT account to Trust account. /s/Amy L. Grant, by Power of Attorney 2022-02-11