UNITED
STATES
SECURITIES
AND EXCHANGE COMMISSION
WASHINGTON,
D.C. 20549
FORM
15
CERTIFICATION
AND NOTICE OF TERMINATION OF REGISTRATION UNDER SECTION 12(G) OF THE SECURITIES
EXCHANGE ACT OF 1934 OR SUSPENSION OF DUTY TO FILE REPORTS UNDER SECTIONS 13 AND
15(D) OF THE SECURITIES EXCHANGE ACT OF 1934.
Commission
File Number 0-50248
NICOLET
BANKSHARES, INC.
(Exact
name of registrant as specified in its charter)
110 South
Washington Street, Green Bay, Wisconsin 54301 (920) 430-1400
(Address,
including zip code, and telephone number, including area code, of registrant's
principal executive offices)
Common
Stock, $.01 par value
(Title of
each class of securities covered by this Form)
None
(Titles
of all other classes of securities for which a duty to file reports under
Section
13 (a) or 15(d) remains)
Please
place an X in the box(es) to designate the appropriate rule provision(s) relied
upon to terminate or suspend the duty to file reports:
|
Rule
12g-4(a)(1)(i) |
x |
|
Rule
12h-3(b)(1)(i) |
x |
|
Rule
12g-4(a)(1)(ii) |
o |
|
Rule
12h-3(b)(1)(ii) |
|
|
Rule
12g-4(a)(2)(i) |
|
|
Rule
12h-3(b)(2)(i) |
|
|
Rule
12g-4(a)(2)(ii) |
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|
Rule
12h-3(b)(2)(ii) |
|
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|
Rule
15d-6 |
|
Approximate
number of holders of record as of the certification or notice date:
233
Pursuant
to the requirements of the Securities Exchange Act of 1934, Nicolet Bankshares,
Inc., has caused this certification/notice to be signed on its behalf by the
undersigned duly authorized person.
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| Date: March 18, 2005 |
By: |
/s/ Robert B. Atwell |
| |
Robert B. Atwell |
| |
Nicolet Bankshares,
Inc. |
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