0001209191-21-007711.txt : 20210204 0001209191-21-007711.hdr.sgml : 20210204 20210204152948 ACCESSION NUMBER: 0001209191-21-007711 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20201231 FILED AS OF DATE: 20210204 DATE AS OF CHANGE: 20210204 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Shaffer Dennis G CENTRAL INDEX KEY: 0001509681 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36192 FILM NUMBER: 21590886 MAIL ADDRESS: STREET 1: 2606 OPEN BAY COURT CITY: GALENA STATE: OH ZIP: 43021 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 5 1 doc5.xml FORM 5 SUBMISSION X0306 5 2020-12-31 0 0 0 0000944745 CIVISTA BANCSHARES, INC. CIVB 0001509681 Shaffer Dennis G 2141 BAILIWICK DRIVE MARBLEHEAD OH 43440 1 1 0 0 CEO and President Common 2020-08-01 5 J 0 53.74 0.00 A 13824.74 D Common 2020-11-02 5 J 0 48.935 0.00 A 13873.675 D Common 2020-08-01 5 J 0 10.534 0.00 A 1288.534 I IRA Common 2020-11-02 5 J 0 9.592 0.00 A 1298.126 I IRA Common shares acquired by company dividend reinvestment feature. /s/ Am L. Grant, by Power of Attorney 2021-02-04