SEC Form 4 · accession 0001209191-18-004514
Citizens Community Bancorp Inc. · CZWI
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
David B Westrate
Director
Period of report
Jan 17, 2018
Accepted (ET)
Jan 19, 2018 · 3:47 pm EST
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 | Jan 17, 2018 | A | 257 | $0.00 | A | 94,026 | D | |
| Common Stock, par value $0.01 per share | holding | — | — | — | 10,753 | I | By Scranton Street Holdings, LP | |
| Common Stock, par value $0.01 per share | holding | — | — | — | 6,100 | I | By Oakdale LLC | |
| Common Stock, par value $0.01 per share | holding | — | — | — | 2,866 | I | By Northshore Partnership LTD. |
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) | $7.04 | holding | — | — | — | Feb 4, 2010 | Feb 4, 2020 | Common Stock | 12,740 | 12,740 | D |
Explanation of responses
- F1Represents restricted shares of Common Stock awarded under the Company's 2008 Equity Incentive Plan, which shares vest on March 27, 2018.