SEC Form 4 · accession 0001209191-17-049678
Citizens Community Bancorp Inc. · CZWI
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Stephen M Bianchi
Officer — CEO and President
Period of report
Aug 21, 2017
Accepted (ET)
Aug 21, 2017 · 11:51 am 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 | Aug 21, 2017 | A | 5,495 | $0.00 | A | 17,086 | D | |
| Common Stock, par value $0.01 per shareF2 | holding | — | — | — | 9,500 | I | By IRA |
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)F3 | $11.00 | holding | — | — | — | — | Jun 24, 2026 | Common Stock | 20,000 | 20,000 | D |
Explanation of responses
- F1Represents restricted shares of Common Stock awarded under the Company's 2008 Equity Incentive Plan, which shares vest as follows: 50% of the shares vest on each of May 25, 2018 and May 25, 2019.
- F2These shares are held in the reporting person's self-directed IRA.
- F3The common stock option awarded under the Company's 2008 Equity Incentive Plan vests as follows: 20% of the shares vest on each of June 24, 2017, June 24, 2018, June 24, 2019, June 24, 2020 and June 24, 2021.