# EDGAR Filing Document

**Accession Number:** 0001255208
**File Stem:** 0001209191-23-005066
**Filing Date:** 2023-1
**Character Count:** 6286
**Document Hash:** a4e0b4b7128819bcc079eaabee625350
**Contains OCR:** False
**Source Format:** 

## Filing Content

## Filing Summary
**0001209191-23-005066.hdr.sgml**: 20230126

**ACCESSION NUMBER**: 0001209191-23-005066

**CONFORMED SUBMISSION TYPE**: 5

**PUBLIC DOCUMENT COUNT**: 1

**CONFORMED PERIOD OF REPORT**: 20221231

**FILED AS OF DATE**: 20230126

**DATE AS OF CHANGE**: 20230126

**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** DUTTON RICHARD J
- **CENTRAL INDEX KEY:** 0001255208

**FILING VALUES:**
- **FORM TYPE:** 5
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-36192
- **FILM NUMBER:** 23558316
**ISSUER**: 

**COMPANY DATA:**
- **COMPANY CONFORMED NAME:** CIVISTA BANCSHARES, INC.
- **CENTRAL INDEX KEY:** 0000944745
- **STANDARD INDUSTRIAL CLASSIFICATION:** STATE COMMERCIAL BANKS [6022]
- **IRS NUMBER:** 341558688
- **STATE OF INCORPORATION:** OH
- **FISCAL YEAR END:** 1231

**BUSINESS ADDRESS:**
- **STREET 1:** 100 EAST WATER ST
- **STREET 2:** P O BOX 5016
- **CITY:** SANDUSKY
- **STATE:** OH
- **ZIP:** 44870
- **BUSINESS PHONE:** 4196254121

**MAIL ADDRESS:**
- **STREET 1:** 100 EAST WATER ST
- **STREET 2:** P O BOX 5016
- **CITY:** SANDUSKY
- **STATE:** OH
- **ZIP:** 44870

**FORMER COMPANY:**
- **FORMER CONFORMED NAME:** FIRST CITIZENS BANC CORP /OH
- **DATE OF NAME CHANGE:** 19950502

### UNITED STATES SECURITIES AND EXCHANGE COMMISSION
**Washington, D.C. 20549**

## FORM 5

### STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

[ ] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).

[ ] Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan for the purchase or sale of equity securities of the issuer that is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10.

---

| | | |
|:---|:---|:---|
| **1. Name and Address of Reporting Person**<sup>*</sup><br>DUTTON RICHARD J<br><sub>(Last) (First) (Middle)</sub><br>325 COUNTRYSIDE DR<br><sub>(Street)</sub><br>TROY, OH 45373-4561<br><sub>(City) (State) (Zip)</sub> | **3. Date of Earliest Transaction (Month/Day/Year)**<br>2022-12-31 | **5. Relationship of Reporting Person(s) to Issuer**<br>(Check all applicable)<br>[ ] Director [ ] 10% Owner<br>[X] Officer (give title below) [ ] Other (specify below)<br>_Senior Vice President_ |
| **2. Issuer Name and Ticker or Trading Symbol**<br>CIVISTA BANCSHARES, INC. [ CIVB ] | **4. If Amendment, Date of Original Filed (Month/Day/Year)**<br>  | **6. Individual or Joint/Group Filing (Check Applicable Line)**<br>[X] Form filed by One Reporting Person<br>[ ] Form filed by More than One Reporting Person |

---

## Table I - Non-Derivative Securities

---

|  |  |  |  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Security | 2. Transaction Date | 2A. Deemed Execution Date | 3. Transaction Code (V) | 3. Transaction Code (V) | 4. Securities Acquired (A) or Disposed of (D) | 4. Securities Acquired (A) or Disposed of (D) | 4. Securities Acquired (A) or Disposed of (D) | 5. Amount of Securities Beneficially Owned | 6. Ownership Form | 7. Nature of Indirect Beneficial Ownership |
| 1. Title of Security | 2. Transaction Date | 2A. Deemed Execution Date | Code | V | Amount | (A) or (D) | Price | 5. Amount of Securities Beneficially Owned | 6. Ownership Form | 7. Nature of Indirect Beneficial Ownership |
| Common | 2022-03-01 |  | J |  | 40.787 | A | $0.00 | 6977.716 | I | IRA |
| Common | 2022-05-25 |  | J |  | 46.029 | A | $0.00 | 7023.745 | I | IRA |
| Common | 2022-08-23 |  | J |  | 44.273 | A | $0.00 | 7068.018 | I | IRA |
| Common | 2022-11-22 |  | J |  | 41.891 | A | $0.00 | 7109.909 | I | IRA |
| Common | 2022-05-25 |  | J |  | 25.5479 | A | $0.00 | 17434.2688 | D |  |
| Common | 2022-05-25 |  | J |  | 40.07 | A | $0.00 | 17474.3388 | D |  |
| Common | 2022-08-23 |  | J |  | 24.8228 | A | $0.00 | 17499.1616 | D |  |
| Common | 2022-08-23 |  | J |  | 42.389 | A | $0.00 | 17541.5506 | D |  |
| Common | 2022-11-22 |  | J |  | 23.4905 | A | $0.00 | 17565.0411 | D |  |
| Common | 2022-11-22 |  | J |  | 40.108 | A | $0.00 | 17605.1491 | D |  |
| Common |  |  |  |  |  |  |  | 7109.909 | I | IRA |
| Common |  |  |  |  |  |  |  | 17605.1491 | D |  |
| Common |  |  |  |  |  |  |  | 1278 | D |  |

---

## Table II - Derivative Securities

---

|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Derivative Security | 2. Conversion or Exercise Price | 3. Transaction Date | 3A. Deemed Execution Date | 4. Transaction Code (V) | 4. Transaction Code (V) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) | 6. Date Exercisable and Expiration Date | 6. Date Exercisable and Expiration Date | 7. Title and Amount of Underlying Securities | 7. Title and Amount of Underlying Securities | 8. Price of Derivative Security | 9. Number of Derivative Securities Beneficially Owned | 10. Ownership Form | 11. Nature of Indirect Beneficial Ownership |
| 1. Title of Derivative Security | 2. Conversion or Exercise Price | 3. Transaction Date | 3A. Deemed Execution Date | Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | 8. Price of Derivative Security | 9. Number of Derivative Securities Beneficially Owned | 10. Ownership Form | 11. Nature of Indirect Beneficial Ownership |
|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |

---

**Signature:** /s/Lori A. Castillo, By Power of Attorney  
**Date:** 2023-01-26

### Remarks:

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.

**Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.**