SEC Form 4 · accession 0001042167-15-000042
Citizens Community Bancorp Inc. · CZWI
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Edward H Schaefer
Officer — Chief Exec Officer & President
Period of report
Mar 9, 2015
Accepted (ET)
Mar 10, 2015 · 4:14 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001367859
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock, par value $.01 per share | Mar 9, 2015 | M | 4,644 | $5.00 | A | 65,146 | D | |
| Common Stock, par value $.01 per share | Mar 9, 2015 | M | 4,644 | $5.48 | A | 69,790 | D | |
| Common Stock, par value $.01 per share | Mar 9, 2015 | M | 9,200 | $5.56 | A | 78,990 | D | |
| Common Stock, par value $.01 per shareF1 | Mar 10, 2015 | S | 2,700 | $9.12 | D | 76,290 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Common Stock Option (right to buy)F2 | $5.00 | Mar 9, 2015 | M | 4,644 | D | Sep 30, 2012 | Sep 30, 2021 | Common Stock | 4,644 | 9,287 | D |
| Common Stock Option (right to buy)F3 | $5.48 | Mar 9, 2015 | M | 4,644 | D | Jun 14, 2012 | Jun 14, 2021 | Common Stock | 4,644 | 9,287 | D |
| Common Stock Option (right to buy)F4 | $5.56 | Mar 9, 2015 | M | 9,200 | D | Oct 31, 2013 | Oct 31, 2022 | Common Stock | 9,200 | 14,019 | D |
Explanation of responses
- F1The price reported above is the average transaction price. The range of prices for such transactions is $9.10 to $9.20. Upon request by the Commission staff, the reporting person will provide full information regarding the number of shares sold at each separate price.
- F2The common stock option vests pro rata over a five-year period: 20% of the shares become exercisable on each of September 30, 2012, September 30, 2013, September 30, 2014, September 30, 2015 and September 30, 2016.
- F3The common stock option vests pro rata over a five-year period: 20% of the shares become exercisable on each of June 14, 2012, June 14, 2013, June 14, 2014, June 14, 2015 and June 14, 2016.
- F4The common stock option vests pro rata over a five-year period: 20% of the shares become exercisable on each of October 31, 2013, October 31, 2014, October 31, 2015, October 31, 2016 and October 31, 2017.