0001042167-11-000222.txt : 20111214 0001042167-11-000222.hdr.sgml : 20111214 20111214160400 ACCESSION NUMBER: 0001042167-11-000222 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20111209 FILED AS OF DATE: 20111214 DATE AS OF CHANGE: 20111214 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Swenson Michael L CENTRAL INDEX KEY: 0001384583 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33003 FILM NUMBER: 111261209 MAIL ADDRESS: STREET 1: 1414 WEST HAMILTON AVE. STREET 2: STE 3 CITY: EAU CLAIRE STATE: WI ZIP: 54701 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Citizens Community Bancorp Inc. CENTRAL INDEX KEY: 0001367859 STANDARD INDUSTRIAL CLASSIFICATION: SAVINGS INSTITUTION, FEDERALLY CHARTERED [6035] IRS NUMBER: 000000000 STATE OF INCORPORATION: MD FISCAL YEAR END: 0930 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 primary_doc.xml PRIMARY DOCUMENT X0304 4 2011-12-09 0 0001367859 Citizens Community Bancorp Inc. CZWI 0001384583 Swenson Michael L C/O CITIZENS COMMUNITY BANCORP, INC. 2174 EASTRIDGE CENTER EAU CLAIRE WI 54701 1 0 0 0 Common Stock, par value $.01 per share 2011-12-09 4 P 0 400 4.95 A 2000 D /s/ Michael L. Swenson 2011-12-09