SEC Form 4 · accession 0001367859-18-000131
Citizens Community Bancorp Inc. · CZWI
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
James R Lang
Director
Period of report
Oct 25, 2018
Accepted (ET)
Oct 29, 2018 · 8:37 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 $.01 per shareF1 | Oct 25, 2018 | A | 1,792 | $0.00 | A | 2,307 | D | |
| Common Stock, par value $.01 per shareF2 | holding | — | — | — | 49,230 | I | By IRA | |
| Common Stock, par value $.01 per shareF3 | holding | — | — | — | 8,460 | I | By Roth IRA | |
| Common Stock, par value $.01 per shareF4 | holding | — | — | — | 3,980 | I | By James & Patricia Lang Grandchildren Education Trust | |
| Common Stock, par value $.01 per shareF5 | holding | — | — | — | 2,500 | I | By Leah Delaney Karge Trust |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1Represents restricted shares of Common Stock awarded under the Company's 2018 Equity Incentive Plan, which shares vest on December 31, 2019.
- F2These shares are held in the reporting person's self-directed IRA.
- F3These shares are held in the reporting person's self-directed Roth IRA.
- F4These shares are held by the James & Patricia Lang Grandchildren Education Trust UAD 01/01/2002, pursuant to which Mr. Lang serves as an investment manager and has investment discretion over such shares. Mr. Lang disclaims beneficial ownership of these shares except to the extent of his pecuniary interest therein.
- F5These shares are held by the Leah Delaney Karge Trust pursuant to which Mr. Lang serves as trustee and has investment discretion. Mr. Lang disclaims beneficial ownership of these shares except to the extent of his pecuniary interest therein.