0001209191-21-008440.txt : 20210208
0001209191-21-008440.hdr.sgml : 20210208
20210208133903
ACCESSION NUMBER: 0001209191-21-008440
CONFORMED SUBMISSION TYPE: 5/A
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20201231
FILED AS OF DATE: 20210208
DATE AS OF CHANGE: 20210208
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: WURM GERALD B
CENTRAL INDEX KEY: 0001193469
FILING VALUES:
FORM TYPE: 5/A
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36192
FILM NUMBER: 21600634
MAIL ADDRESS:
STREET 1: 100 EAST WATER STREET
CITY: SANDUSKY
STATE: OH
ZIP: 44870
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/A
1
doc5a.xml
FORM 5/A SUBMISSION
X0306
5/A
2020-12-31
2021-02-04
0
0
0
0000944745
CIVISTA BANCSHARES, INC.
CIVB
0001193469
WURM GERALD B
4905 ALBAUGH ROAD
NEW WASHINGTON
OH
44854
0
0
0
1
Subsidiary Director
Common
2020-11-02
5
J
0
262.081
0.00
A
36811.196
I
Trust
Common
1275
I
Grandson #1 Trust
Common
51461
I
Trust
Common
32253
I
Mary L. Wurm Trust
Reflects shares in dividend reinvestment. Total of 11/02/2020 reinvestment was 276.609 (14.528 was reported on 02/04/21 + the difference of 262.081 reported in this amended filing)
/s/ Amy L. Grant, by Power of Attorney
2021-02-08