SEC Form 4 · accession 0001367859-18-000164
Citizens Community Bancorp Inc. · CZWI
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
James S Broucek
Officer — EVP/CFO/Treasurer/Secretary
Period of report
Nov 16, 2018
Accepted (ET)
Nov 20, 2018 · 12:13 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 | Nov 16, 2018 | P | 600 | $11.99 | A | 25,156 | I | By IRA |
| Common Stock, par value $0.01 per share | holding | — | — | — | 4,905 | 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)F2 | $13.60 | holding | — | — | — | — | Oct 31, 2027 | Common Stock | 8,000 | 8,000 | D |
Explanation of responses
- F1These shares are held in the reporting person's self-directed IRA.
- F2The 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.