| | | | | | | | | | | | | | | | | | | | | | |
Ownership Document
|
| Schema Version: X0508 |
| Document Type: 4 |
| Period of Report: 1/25/24 |
| Not Subject to Section 16: 0 |
| Issuer: |
| Issuer CIK: 1367859 |
| Issuer Name: Citizens Community Bancorp Inc. |
| Issuer Trading Symbol: CZWI |
| Reporting Owner: |
| Reporting Owner ID: |
| | Owner CIK: 1266296 |
| | Owner Name: SKARVAN KATHLEEN |
| Reporting Owner Address: |
| | Owner Street 1: C/O CITIZENS COMMUNITY BANCORP, INC. |
| | Owner Street 2: 2174 EASTRIDGE CENTER |
| | Owner City: EAU CLAIRE |
| | Owner State: WI |
| | Owner ZIP Code: 54701 |
| | Owner State Description: |
| Reporting Owner Relationship: |
| | Is Director? Yes |
| | Is Officer? No |
| | Is Ten Percent Owner? No |
| | Is Other? No |
| | Other Text: |
| Aff 10b5 One: 0 |
| Non-Derivative Table: |
| Non-Derivative Transaction: |
| | Security Title: |
| | | Value: Common Stock, par value $0.01 per share |
| | Transaction Date: |
| | | Value: 1/25/24 |
| | Transaction Coding: |
| | | Transaction Form Type: 4 |
| | | Transaction Code: A |
| | | Equity Swap Involved? No |
| | Transaction Amounts: |
| | | Transaction Shares: |
| Value: 1,893 |
| Footnote ID: F1 |
| | | Transaction Price Per Share: |
| Value: 11.88 |
| | | Transaction Acquired-Disposed Code: |
| Value: A |
| | Post-Transaction Amounts: |
| | | Shares Owned Following Transaction: |
| Value: 8,601 |
| | Ownership Nature: |
| | | Direct or Indirect Ownership: |
| Value: D |
| Non-Derivative Holding: |
| | Security Title: |
| | | Value: Common Stock, par value $.01 per share |
| | Post-Transaction Amounts: |
| | | Shares Owned Following Transaction: |
| Value: 300 |
| | Ownership Nature: |
| | | Direct or Indirect Ownership: |
| Value: I |
| | | Nature of Ownership: |
| Value: By PK Skarvan Trust |
| Footnote ID: F2 |
| Derivative Table: |
| Footnotes: |
| Footnote - F1: Represents restricted shares of Common Stock awarded under the Company's 2018 Equity Incentive Plan, which shares vest December 31, 2024. |
| Footnote - F2: These shares are held by the PK Skarvan Trust pursuant to which Kathleen Skarvan and Paul Skarvan are trustees. |
| Remarks: |
| Owner Signature: |
| Signature Name: /s/ Rebecca L. Johnson, Attorney-in-fact |
| Signature Date: 1/29/24 |
