SEC Form 5 · accession 0001127602-17-006044
NICOLET BANKSHARES INC · NIC
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Donald J Long Jr.
Director
Period of report
Dec 31, 2016
Accepted (ET)
Feb 14, 2017 · 5:34 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001174850
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Feb 24, 2016 | J | 2 | $0.00 | A | 99,521 | D | |
| Common Stock | holding | — | — | — | 2,009 | I | By Nicolet National Bank Deferred Compensation Plan For Non-employee Directors |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1An adjustment of 2 shares omitted from the reporting person's original Form 3 filed on February 24, 2016. These shares were also omitted from one Form 4 filed by the reporting person after the original Form 3 was filed.