0001209191-23-019175.txt : 20230316 0001209191-23-019175.hdr.sgml : 20230316 20230316143730 ACCESSION NUMBER: 0001209191-23-019175 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230314 FILED AS OF DATE: 20230316 DATE AS OF CHANGE: 20230316 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Waltz-Jaskolski Donna M. CENTRAL INDEX KEY: 0001718888 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36192 FILM NUMBER: 23738382 MAIL ADDRESS: STREET 1: 100 TIA TRAIL CITY: LOWELL STATE: MI ZIP: 49331 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 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2023-03-14 0 0000944745 CIVISTA BANCSHARES, INC. CIVB 0001718888 Waltz-Jaskolski Donna M. 1730 SANDPIPER COURT HURON OH 44839 0 1 0 0 Senior Vice President Common 2023-01-03 4 F 0 327 21.52 D 2677 D Common 2023-03-14 4 A 0 1467 0.00 A 4144 D Reflects shares withheld by the company for payment of taxes upon vesting of restricted shares. Restricted shares granted from Civista Bancshares Inc's 2017 Incentive Plan are subject to time-based vesting. /s/ Lori A. Castillo, By Power of Attorney 2023-03-16