SEC Form 4 · accession 0001209191-18-017710
Citizens Community Bancorp Inc. · CZWI
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
James S Broucek
Officer — Chief Financial Officer
Period of report
Mar 5, 2018
Accepted (ET)
Mar 7, 2018 · 4:16 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,F2 | Mar 5, 2018 | P | 1,500 | $13.95 | A | 12,366 | I | By IRA |
| Common Stock, par value $0.01 per shareF2 | Mar 6, 2018 | P | 1,000 | $13.96 | A | 13,366 | I | By IRA |
| Common Stock, par value $0.01 per share | holding | — | — | — | 4,000 | 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)F3 | $13.60 | holding | — | — | — | — | Oct 31, 2027 | Common Stock | 8,000 | 8,000 | D |
Explanation of responses
- F1The price reported in Column 4 is a weighted average price. These shares were purchased in multiple transactions at the price of $13.95. The reporting person undertakes to provide the SEC staff, Citizens Community Bancorp, Inc., or any security holder of Citizens Community Bancorp, Inc., upon request, full information regarding the number of shares purchased at the price set forth in this footnote.
- 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 October 31, 2018, October 31, 2019, October 31, 2020, October 31, 2021 and October 31, 2022.