0001367859-23-000116.txt : 20230614
0001367859-23-000116.hdr.sgml : 20230614
20230614092633
ACCESSION NUMBER: 0001367859-23-000116
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20230612
FILED AS OF DATE: 20230614
DATE AS OF CHANGE: 20230614
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: SKARVAN KATHLEEN
CENTRAL INDEX KEY: 0001266296
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-33003
FILM NUMBER: 231013155
MAIL ADDRESS:
STREET 1: 40 WEST HIGHLAND PARK DR NE
CITY: HUTCHINSON
STATE: MN
ZIP: 55350
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Citizens Community Bancorp Inc.
CENTRAL INDEX KEY: 0001367859
STANDARD INDUSTRIAL CLASSIFICATION: SAVINGS INSTITUTION, FEDERALLY CHARTERED [6035]
IRS NUMBER: 205120010
STATE OF INCORPORATION: MD
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 2174 EASTRIDGE CENTER
CITY: EAU CLAIRE
STATE: WI
ZIP: 54701
BUSINESS PHONE: 715 836 9994
MAIL ADDRESS:
STREET 1: 2174 EASTRIDGE CENTER
CITY: EAU CLAIRE
STATE: WI
ZIP: 54701
4
1
wk-form4_1686749184.xml
FORM 4
X0407
4
2023-06-12
0
0001367859
Citizens Community Bancorp Inc.
CZWI
0001266296
SKARVAN KATHLEEN
C/O CITIZENS COMMUNITY BANCORP, INC.
2174 EASTRIDGE CENTER
EAU CLAIRE
WI
54701
1
0
0
0
0
Common Stock, par value $.01 per share
2023-06-12
4
P
0
300
8.80
A
300
I
By PK Skarvan Trust
Common Stock, par value $0.01 per share
6708
D
These shares are held by the PK Skarvan Trust pursuant to which Kathleen Skarvan and Paul Skarvan are trustees.
/s/ Rebecca L. Johnson, Attorney-in-fact
2023-06-14