0001209191-22-008719.txt : 20220211
0001209191-22-008719.hdr.sgml : 20220211
20220211113803
ACCESSION NUMBER: 0001209191-22-008719
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: Shaffer Dennis G
CENTRAL INDEX KEY: 0001509681
FILING VALUES:
FORM TYPE: 5
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36192
FILM NUMBER: 22618075
MAIL ADDRESS:
STREET 1: 2606 OPEN BAY COURT
CITY: GALENA
STATE: OH
ZIP: 43021
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
0001509681
Shaffer Dennis G
2141 BAILIWICK DRIVE
MARBLEHEAD
OH
43440
1
1
0
0
CEO and President
Common
2021-05-01
5
J
0
22.0428
0.00
A
19938.2758
D
Common
2021-05-01
5
J
0
34.236
0.00
A
19972.5118
D
Common
2021-08-02
5
J
0
26.038
0.00
A
19998.5498
D
Common
2021-08-02
5
J
0
40.832
0.00
A
20039.3818
D
Common
2021-11-01
5
J
0
24.4367
0.00
A
20063.8185
D
Common
2021-11-01
5
J
0
37.691
0.00
A
20101.5095
D
Common
2021-05-01
5
J
0
6.71
0.00
A
1313.832
I
IRA
Common
2021-08-02
5
J
0
8.004
0.00
A
1321.836
I
IRA
Common
2021-11-01
5
J
0
7.388
0.00
A
1329.224
I
IRA
Common shares acquired by company dividend reinvestment feature.
/s/Amy L. Grant, by Power of Attorney
2021-12-31