# EDGAR Filing Document

**Accession Number:** 0001174850
**File Stem:** 0001127602-23-001851
**Filing Date:** 2023-1
**Character Count:** 7538
**Document Hash:** 59c26e8d58579daa4c5d1a9bf7b4f823
**Contains OCR:** False
**Source Format:** 

## Filing Content

## Filing Summary
**0001127602-23-001851.hdr.sgml**: 20230119

**ACCESSION NUMBER**: 0001127602-23-001851

**CONFORMED SUBMISSION TYPE**: 4

**PUBLIC DOCUMENT COUNT**: 1

**CONFORMED PERIOD OF REPORT**: 20230117

**FILED AS OF DATE**: 20230119

**DATE AS OF CHANGE**: 20230119

**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** WEYERS ROBERT J
- **CENTRAL INDEX KEY:** 0001243734

**FILING VALUES:**
- **FORM TYPE:** 4
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-37700
- **FILM NUMBER:** 23538426

**MAIL ADDRESS:**
- **STREET 1:** C/O NICOLET NATIONAL BANK
- **STREET 2:** 111 NORTH WASHINGTON STREET
- **CITY:** GREEN BAY
- **STATE:** WI
- **ZIP:** 54301
**ISSUER**: 

**COMPANY DATA:**
- **COMPANY CONFORMED NAME:** NICOLET BANKSHARES INC
- **CENTRAL INDEX KEY:** 0001174850
- **STANDARD INDUSTRIAL CLASSIFICATION:** NATIONAL COMMERCIAL BANKS [6021]
- **IRS NUMBER:** 000000000
- **STATE OF INCORPORATION:** WI
- **FISCAL YEAR END:** 1231

**BUSINESS ADDRESS:**
- **STREET 1:** 111 N WASHINGTON ST
- **CITY:** GREEN BAY
- **STATE:** WI
- **ZIP:** 54301
- **BUSINESS PHONE:** 920 430 1400

**MAIL ADDRESS:**
- **STREET 1:** 111 N WASHINGTON ST
- **CITY:** GREEN BAY
- **STATE:** WI
- **ZIP:** 54301

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

## FORM 4

### 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>WEYERS ROBERT J<br><sub>(Last) (First) (Middle)</sub><br>C/O NICOLET NATIONAL BANK<br>111 NORTH WASHINGTON STREET<br><sub>(Street)</sub><br>GREEN BAY, WI 54301<br><sub>(City) (State) (Zip)</sub> | **3. Date of Earliest Transaction (Month/Day/Year)**<br>2023-01-17 | **5. Relationship of Reporting Person(s) to Issuer**<br>(Check all applicable)<br>[X] Director [ ] 10% Owner<br>[ ] Officer (give title below) [ ] Other (specify below)<br>_ _ |
| **2. Issuer Name and Ticker or Trading Symbol**<br>NICOLET BANKSHARES INC [ NIC ] | **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 Stock | 2023-01-17 |  | A |  | 81<sup>(1)</sup> | A | $80.30 | 8534 | I | By Nicolet National Bank Deferred Compensation Plan For Non-employee Directors |
| Common Stock |  |  |  |  |  |  |  | 87715<sup>(2)</sup> | D |  |
| Common Stock |  |  |  |  |  |  |  | 3500 | I | by RJW Family Investments  LLC<sup>(3)</sup> |
| Common Stock |  |  |  |  |  |  |  | 4000 | I | By Ronald and Colleen Weyers Grandchildren's Trust #2<sup>(4)</sup> |
| Common Stock |  |  |  |  |  |  |  | 25250 | I | By Weyers Family Limited Partnership<sup>(5)</sup> |

---

## 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 |
|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |

---

### Footnotes:

(1) Mr. Weyers acquired 81 shares in the Nicolet National Bank Deferred Compensation Plan for Non-employee Directors by deferring his fourth quarter 2022 earned board fees.

(2) Reflects an adjustment of 9 shares omitted from Mr. Weyers original Form 3 filed on February 24, 2016.  These shares were also omitted from 38 Form 4's filed by Mr. Weyers after the original Form 3 was filed.

(3) Represents the holdings of RJW Family Investments, LLC of which the reporting person is an owner.  The reporting person disclaims beneficial ownership of registrant common stock held by RJW Family Investments, LLC except to the extent of his pecuniary interest.

(4) Represents the holdings of Ronald and Colleen Weyers Grandchildren's Trust #2 of which the reporting person is trustee. The reporting person disclaims beneficial ownership of registrant common stock held by Ronald and Colleen Weyers Grandchildren's Trust #2 except to the extent of his pecuniary interest.

(5) Represents the holdings of Weyers Family Limited Partnership, of which the reporting person is a general partner.  The reporting person disclaims beneficial ownership of registrant common stock held by Weyers Family Limited Partnership except to the extent of his pecuniary interest.

**Remarks:**
Mr. Weyers previously reported indirect ownership of 20,000 shares through WB Regency Limited Partnership, which he is general partner.  The partnership distributed all 20,000 shares to the limited partners.  Mr. Weyers did not receive any of the distributed shares from the partnership.

**Signature:** /s/ H. Phillip Moore, Jr., as attorney-in-fact for Robert J. Weyers  
**Date:** 2023-01-19

### 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.**