SEC Form 4/A · accession 0001144204-16-108698
Citizens Community Bancorp Inc. · CZWI
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
This is an amendment (Form 4/A). It replaces an earlier filing for the same period.
Reporting owner
Edward H Schaefer
Officer — CEO and President
Period of report
Jun 14, 2016
Accepted (ET)
Jun 17, 2016 · 12:35 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 $0.01 per shareF1 | Jun 14, 2016 | F | 639 | $9.62 | D | 76,699 | D | |
| Common Stock, par value $0.01 per share | Jun 14, 2016 | M | 4,643 | $5.48 | A | 81,342 | 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 | $5.48 | Jun 14, 2016 | M | 4,643 | D | Jun 14, 2016 | Jun 14, 2021 | Common Stock | 4,643 | 0 | D |
Explanation of responses
- F1The reporting person surrendered a total of 639 shares of the Company's common stock to satisfy the withholding taxes due upon the vesting of certain previously awarded shares of restricted stock issued under the Company's 2004 Recognition and Retention Plan .
- F2The common stock option vests pro rata over a five-year period: 20% of the shares become exercisable on each June 14, 2012, June 14, 2013, June 14, 2014, June 14, 2015 and June 14, 2016.