0001209191-22-055917.txt : 20221107 0001209191-22-055917.hdr.sgml : 20221107 20221107144817 ACCESSION NUMBER: 0001209191-22-055917 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20221103 FILED AS OF DATE: 20221107 DATE AS OF CHANGE: 20221107 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: NICKLES ALLEN R CENTRAL INDEX KEY: 0001265669 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36192 FILM NUMBER: 221365081 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 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2022-11-03 0 0000944745 CIVISTA BANCSHARES, INC. CIVB 0001265669 NICKLES ALLEN R 3308 E BEVERLY DRIVE SANDUSKY OH 44870 1 0 0 0 Common 2021-05-27 4 A 0 628 0.00 A 4585 D Common 2022-03-03 4 S 0 5000 24.25 D 109759 I SEP IRA Common 2022-03-17 4 J 0 725 0.00 D 0 I Daughter Common 2022-05-25 4 A 0 602 0.00 A 5187 D Common 2022-11-03 4 S 0 10000 22.754 D 99759 I SEP IRA /s/ Lori A. Castillo, by Power of Attorney 2022-11-07 EX-24 2 poa.txt POA DOCUMENT Allen R. Nickles LIMITED POWER OF ATTORNEY SECURITIES LAW COMPLIANCE The undersigned hereby constitutes and appoints Lori A. Castillo and Karen M. Terenzi as the undersigned's true and lawful attorneys-in-fact and agents to complete and execute such Forms 144, Forms 3, 4 and 5 and other forms (collectively, the "Reporting Forms") as such attorneys-in-fact shall, in her discretion, determine to be required or advisable pursuant to Rule 144 promulgated under the Securities Act of 1933 (as amended), Section 16 of the Securities Exchange Act of 1934 (as amended) and the rules and regulations promulgated thereunder, or any successor laws and regulations (collectively, "SEC Law"), as a consequence of the undersigned's ownership, acquisition or disposition of securities of Civista Bancshares, Inc. (the "Corporation"), and to do all acts necessary in order to file such forms with the Securities and Exchange Commission (the "SEC"), any securities exchange or national association, the Corporation and such other person or agency as the attorneys-in-fact shall deem appropriate. Said attorneys-in-fact and agents have the authority to act individually. The undersigned hereby ratifies and confirms all that said attorneys-in-fact and agents shall do or cause to be done by virtue hereof. The undersigned acknowledges that: (1) this Limited Power of Attorney authorizes, but does not require, the attorneys-in-fact to act in her discretion on information provided to such attorneys-in-fact without independent verification of such information; (2) any Reporting Forms prepared and/or executed by the attorneys-in-fact on behalf of the undersigned pursuant to this Limited Power of Attorney will be in such form and will contain such information and disclosure as such attorneys-in-fact, in his discretion, deems necessary or desirable; (3) neither the Corporation nor the attorneys-in-fact assume (i) any liability for the undersigned's responsibility to comply with the requirements of SEC Law, (ii) any liability of the undersigned for any failure to comply with such requirements, or (iii) any obligation or liability of the undersigned for profit disgorgement under Section 16(b) of the Exchange Act; (4) this Limited Power of Attorney does not relieve the undersigned from responsibility for compliance with the undersigned's obligations under SEC Law, including without limitation the reporting requirements under Section 16 of the Exchange Act; and (5) in order to execute any Reporting Forms, it is the undersigned's responsibility to notify the attorneys-in-fact in a timely manner of any transaction regarding the undersigned's ownership, acquisition or disposition of Civista Bancshares, Inc. securities (SEC requires Reporting Forms to be filed within two (2) business days of the transaction). In such instances where the undersigned has executed any of the Reporting Forms on his or her own behalf, the undersigned hereby consents to the filing of copies of such Reporting Forms that reflect a conformed signature. The undersigned will maintain fully executed copies of any Reporting Forms so filed, in his or her own records. This Limited Power of Attorney is executed at Sandusky, Ohio as of the date set forth below. Date: September 27, 2022 Allen R. Nickles State of OHIO County of Erie On this 27th day of September, 2022, before me, the undersigned notary public, appeared Allen R. Nickles, personally known to me or proved to me on the basis of satisfactory evidence to be the individual whose name is subscribed to the within instrument, and acknowledge to me that he executed the same.