0001209191-15-063191.txt : 20150803
0001209191-15-063191.hdr.sgml : 20150801
20150803110147
ACCESSION NUMBER: 0001209191-15-063191
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20150731
FILED AS OF DATE: 20150803
DATE AS OF CHANGE: 20150803
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
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: WURM GERALD B
CENTRAL INDEX KEY: 0001193469
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36192
FILM NUMBER: 151021414
MAIL ADDRESS:
STREET 1: 100 EAST WATER STREET
CITY: SANDUSKY
STATE: OH
ZIP: 44870
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2015-07-31
0
0000944745
CIVISTA BANCSHARES, INC.
CIVB
0001193469
WURM GERALD B
4905 ALBAUGH ROAD
NEW WASHINGTON
OH
44854
0
0
0
1
Subsidiary Director
Common
2015-07-31
4
P
0
2400
10.50
A
51061
I
Trust
Common
2550
I
Grandson #1 Trust
Common
550
I
Grandson #2 Trust
Common
2912.285
I
Trust
Common
0
I
Joint w/spouse - daughter #1's Trust
Common
5000
I
Mary L. Wurm Trust
Depositary Shares
9000
I
Gerald B Wurm Trust UAD 2/26/99
Reflects shares in dividend reinvestment
Reporting person no longer reports as beneficially owned securities owned by daughter
/s/Gerald B. Wurm
2015-08-03