Citizens Community Bancorp Inc.·4

Sep 28, 6:54 PM ET

Lang James R 4

4 · Citizens Community Bancorp Inc. · Filed Sep 28, 2018

Insider Transaction Report

Form 4
Period: 2018-09-28
Lang James R
Director
Transactions
  • Conversion

    Common Stock, par value $.01 per share

    [F1][F2]
    2018-09-28+19,23049,230 total(indirect: By IRA)
  • Conversion

    Common Stock, par value $.01 per share

    [F1][F3]
    2018-09-28+8,4608,460 total(indirect: By IRA)
  • Conversion

    Series A Preferred Stock

    [F1][F2]
    2018-09-281,9230 total(indirect: By IRA)
    Common Stock (19,230 underlying)
  • Conversion

    Series A Preferred Stock

    [F1][F3]
    2018-09-288460 total(indirect: By IRA)
    Common Stock (8,460 underlying)
Holdings
  • Common Stock, par value $.01 per share

    [F4]
    (indirect: By Trust)
    3,980
  • Common Stock, par value $.01 per share

    [F5]
    (indirect: By Trust)
    2,500
  • Common Stock, par value $.01 per share

    515
Footnotes (5)
  • [F1]Each share of 8% Series A Mandatorily Convertible Non-Cumulative Non-Voting Perpetual Stock was mandatorily converted into ten (10) shares of the Company's common stock three days following stockholder approval of the issuance of the underlying common stock and had no expiration date.
  • [F2]These shares are held in the reporting person's self-directed IRA.
  • [F3]These shares are held in the reporting person's self-directed Roth IRA.
  • [F4]These 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.
  • [F5]These 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.
Signature
/s/ Rebecca L. Johnson, by Power of Attorney|2018-09-28

Documents

1 file
  • 4
    wf-form4_153817523227150.xmlPrimary

    FORM 4