0001209191-22-008721.txt : 20220211 0001209191-22-008721.hdr.sgml : 20220211 20220211114905 ACCESSION NUMBER: 0001209191-22-008721 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: Singer Harry CENTRAL INDEX KEY: 0001605759 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36192 FILM NUMBER: 22618169 MAIL ADDRESS: STREET 1: 5309 GOLFWAY LANE CITY: LYNDHURST STATE: OH ZIP: 44124 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 0001605759 Singer Harry 5309 GOLFWAY LANE LYNDHURST OH 44124 1 0 0 0 Common 2021-08-02 5 J 0 29.135 0.00 A 5966.799 D Common 2021-11-01 5 J 0 26.893 0.00 A 5993.692 D Common 7900 I President of Sandusco Inc (corporate owner) Common 1875 I Rollover IRA Common 1075 I SEP IRA /s/Amy L. Grant, by Power of Attorney 2022-02-11