SEC Form 4 · accession 0001367859-18-000080
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 · Director
Period of report
Jun 25, 2018
Accepted (ET)
Jun 26, 2018 · 1:11 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 25, 2018 | F | 581 | $13.75 | D | 30,509 | D | |
| Common Stock, par value $0.01 per shareF2 | holding | — | — | — | 19,241 | 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 |
| Series A Preferred StockF2,F4 | — | holding | — | — | — | — | — | Common Stock | 11,540 | 1,154 | I |
Explanation of responses
- F1The reporting person surrendered a total of 581 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 2008 Equity Incentive Plan.
- 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.
- F4Each share of 8.00% Series A Mandatorily Convertible Non-Cumulative Non-Voting Perpetual Preferred Stock is mandatorily convertible into ten shares of the Company's common stock upon stockholder approval of the issuance of the underlying common stock and has no expiration date.