0001127602-21-016576.txt : 20210513 0001127602-21-016576.hdr.sgml : 20210513 20210513163030 ACCESSION NUMBER: 0001127602-21-016576 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210511 FILED AS OF DATE: 20210513 DATE AS OF CHANGE: 20210513 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Lawson Ann Kuchera CENTRAL INDEX KEY: 0001664666 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37700 FILM NUMBER: 21920101 MAIL ADDRESS: STREET 1: C/O NICOLET BANKSHARES, INC. STREET 2: 111 NORTH WASHINGTON STREET CITY: GREEN BAY STATE: WI ZIP: 54301 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: NICOLET BANKSHARES INC CENTRAL INDEX KEY: 0001174850 STANDARD INDUSTRIAL CLASSIFICATION: NATIONAL COMMERCIAL BANKS [6021] IRS NUMBER: 000000000 STATE OF INCORPORATION: WI FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 111 N WASHINGTON ST CITY: GREEN BAY STATE: WI ZIP: 54301 BUSINESS PHONE: 920 430 1400 MAIL ADDRESS: STREET 1: 111 N WASHINGTON ST CITY: GREEN BAY STATE: WI ZIP: 54301 4 1 form4.xml PRIMARY DOCUMENT X0306 4 2021-05-11 0001174850 NICOLET BANKSHARES INC NCBS 0001664666 Lawson Ann Kuchera C/O NICOLET NATIONAL BANK 111 NORTH WASHINGTON STREET GREEN BAY WI 54301 1 1 Director & CFO Common Stock 2021-05-11 4 M 0 2725 16.50 A 31827 D Common Stock 2021-05-11 4 F 0 567 79.31 D 31260 D Common Stock 800 I By 401(k) Plan Stock Option (Right to Buy) 16.50 2021-05-11 4 M 0 2725 0 D 2022-04-10 Common Stock 2725 0 D Option exercise cost was covered through a stock swap transaction. Includes 8 additional shares acquired under the Employee Stock Purchase Plan since the reporting person's last Form 4 filing on April 12, 2021. The reporting person owns a total of 130 shares in the Employee Stock Purchase Plan as of the date of this report. The stock option is fully exercised as of the date of this report. /s/ Ann K. Lawson 2021-05-13