SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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 Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
Lawson Ann Kuchera
(Last) (First) (Middle)
C/O NICOLET NATIONAL BANK
111 NORTH WASHINGTON STREET
(Street)
GREEN BAY WI 54301
(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
NICOLET BANKSHARES INC [ NCBS ] 		5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Chief Financial Officer
3. Date of Earliest Transaction (Month/Day/Year)
02/23/2021
4. If Amendment, Date of Original Filed (Month/Day/Year)
 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. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction 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 02/23/2021 M 2,800 A $37.18 31,947 D
Common Stock 02/23/2021 F 1,826 D $76.14 30,121 D
Common Stock 02/23/2021 M 5,000 A $48.85 35,121 D
Common Stock 02/23/2021 F 3,781 D $76.14 31,340 D
Common Stock 02/23/2021 S 2,193 D $76.14 29,147(1) D
Common Stock 800 I By 401(k) Plan
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. 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: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Stock Option (Right to Buy) $37.18 02/23/2021 M 2,800 (2) 09/20/2026 Common Stock 2,800 $0 2,000 D
Stock Option (Right to Buy) $48.85 02/23/2021 M 5,000 (3) 05/16/2027 Common Stock 5,000 $0 49,000 D
Explanation of Responses:
1. Includes 11 additional shares acquired under the Employee Stock Purchase Plan since the reporting person's last Form 4 filing on December 9, 2020. The reporting person owns a total of 122 shares in the Employee Stock Purchase Plan as of the date of this report.
2. The remaining nonqualified options outstanding will become exercisable as of September 20, 2021. The nonqualified options grant of 10,000 shares will vest in five annual installments of 2,000 shares annually on September 20 of each year, beginning on September 20, 2017 and fully vests on September 20, 2021.
3. The nonqualified options are currently exercisable to 27,400 shares. The nonqualified options grant of 54,000 shares will vest in five annual installments of 10,800 shares annually on May 16 of each year, beginning on May 16, 2018 and fully vests on May 16, 2022.
/s/ Ann K. Lawson 02/24/2021
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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