0001209191-21-048414.txt : 20210728
0001209191-21-048414.hdr.sgml : 20210728
20210728133404
ACCESSION NUMBER: 0001209191-21-048414
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210728
FILED AS OF DATE: 20210728
DATE AS OF CHANGE: 20210728
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Singer Harry
CENTRAL INDEX KEY: 0001605759
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36192
FILM NUMBER: 211121644
MAIL ADDRESS:
STREET 1: 5309 GOLFWAY LANE
CITY: LYNDHURST
STATE: OH
ZIP: 44124
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
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2021-07-28
0
0000944745
CIVISTA BANCSHARES, INC.
CIVB
0001605759
Singer Harry
5309 GOLFWAY LANE
LYNDHURST
OH
44124
1
0
0
0
Common
2021-07-28
4
P
0
325
23.50
A
1075
I
SEP IRA
Common
7900
I
President of Sandusco Inc (corporate owner)
Common
5937.664
D
Common
1875
I
Rollover IRA
/s/Amy L. Grant, by Power of Attorney
2021-07-28