0001209191-22-008771.txt : 20220211 0001209191-22-008771.hdr.sgml : 20220211 20220211135451 ACCESSION NUMBER: 0001209191-22-008771 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: WHITE DANIEL J CENTRAL INDEX KEY: 0001196384 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36192 FILM NUMBER: 22619182 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 0001196384 WHITE DANIEL J 403 SAIL AWAY DRIVE HURON OH 44839 1 0 0 0 Common 2021-08-02 5 J 0 21.239 0.00 A 3507.717 D Common 2021-09-10 5 J 0 137 0.00 D 3370.717 D Common 2021-09-13 5 J 0 3370.717 0.00 D 0 D Common 2021-09-10 5 J 0 137 0.00 A 79058.326 I LLC Common 2021-09-13 5 J 0 3370 0.00 A 82428.326 I LLC Common shares acquired by company dividend reinvestment feature. Transferred shares to another account. Transferred shares from another account. /s/Amy L. Grant, by Power of Attorney 2022-02-11