Statement of Changes in Beneficial Ownership (4)

Date : 11/20/2019 @ 9:28PM
Source : Edgar (US Regulatory)
Stock : Nicolet Bankshares Inc (NCBS)
Quote : 74.37  1.15 (1.57%) @ 9:30PM
After Hours
Last Trade
Last $ 74.37 ◊ 0.00 (0.00%)

Statement of Changes in Beneficial Ownership (4)

FORM 4 [ ] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).         
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
                                                                                  
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OMB Number: 3235-0287
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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
                      

1. Name and Address of Reporting Person *

DANIELS MICHAEL E
2. Issuer Name and Ticker or Trading Symbol

NICOLET BANKSHARES INC [ NCBS ]
5. Relationship of Reporting Person(s) to Issuer (Check all applicable)

__X__ Director                    _____ 10% Owner
__X__ Officer (give title below)    _____ Other (specify below)
EVP and Secretary
(Last)          (First)          (Middle)

C/O NICOLET NATIONAL BANK, 111 NORTH WASHINGTON STREET
3. Date of Earliest Transaction (MM/DD/YYYY)

11/18/2019
(Street)

GREEN BAY, WI 54301
(City)        (State)        (Zip)
4. If Amendment, Date Original Filed (MM/DD/YYYY)

 
6. Individual or Joint/Group Filing (Check Applicable Line)

_X _ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person

Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Trans. Date 2A. Deemed Execution Date, if any 3. Trans. Code
(Instr. 8)
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 11/18/2019  M  13500 A$23.80 84353 D  
Common Stock 11/18/2019  F  8761 D$70.50 75592 D  
Common Stock 11/18/2019  M  40500 A$25.90 116092 D  
Common Stock 11/18/2019  F  26921 D$70.50 89171 D  
Common Stock 11/18/2019  S  10818 D$70.50 78353 D  
Common Stock 11/18/2019  A  2712 A$70.50 81065 D  
Common Stock 11/18/2019  F  425 D$70.50 80640 D  
Common Stock 11/19/2019  G  V 7500 (1)D$0 73140 (2)D  
Common Stock         6252 I By 401(k) Plan 
Common Stock         9803 I By Spouse 

Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivate Security
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security3. Trans. Date3A. Deemed Execution Date, if any4. Trans. Code
(Instr. 8)
5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
6. Date Exercisable and Expiration Date7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4)
8. Price of Derivative Security
(Instr. 5)
9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4)11. Nature of Indirect Beneficial Ownership (Instr. 4)
CodeV(A)(D)Date ExercisableExpiration DateTitleAmount or Number of Shares
Stock Option (Right to Buy) $23.80 11/18/2019  M     13500   (3)10/28/2024 Common Stock 13500 $0 0 D  
Stock Option (Right to Buy) $25.90 11/18/2019  M     40500   (4)1/20/2025 Common Stock 40500 $0 13500 D  
Stock Option (Right to Buy) $70.50 11/18/2019  A   54000     (5)11/18/2029 Common Stock 54000 $70.50 54000 D  

Explanation of Responses:
(1) Shares gifted to a Donor Advised Trust.
(2) Includes 186 shares acquired under the Employee Stock Purchase Plan to date.
(3) The nonqualified stock option is fully exercised. The options vested in five annual installments of 13,500 shares annually on October 28 of each year, beginning on October 28, 2015 and fully vested on October 28, 2019.
(4) The remaining 13,500 nonqualified options are not currently exercisable. The options vest in five annual installments of 13,500 shares annually on January 20 of each year, beginning on January 20, 2016 and fully vest on January 20, 2020.
(5) The nonqualified options vest in five annual installments of 10,800 shares on November 18 of each year, beginning on November 18, 2020 and will fully vest on November 18, 2024.

Reporting Owners
Reporting Owner Name / Address
Relationships
Director10% OwnerOfficerOther
DANIELS MICHAEL E
C/O NICOLET NATIONAL BANK
111 NORTH WASHINGTON STREET
GREEN BAY, WI 54301
X
EVP and Secretary

Signatures
/s/ Ann K. Lawson, as attorney-in-fact for Michael E. Daniels11/20/2019
**Signature of Reporting PersonDate

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