SEC Form 4 · accession 0000905729-15-000297
CHOICEONE FINANCIAL SERVICES INC · COFS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
James A Bosserd
Officer — Chief Executive Officer · Director
Period of report
Sep 22, 2015
Accepted (ET)
Sep 24, 2015 · 1:39 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000803164
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock | Sep 22, 2015 | M | 1,500 | $18.85 | A | 13,562 | D | |
| Common Stock | Sep 22, 2015 | F | 1,201 | $23.54 | D | 12,361 | D | |
| Common StockF1 | holding | — | — | — | 7,856 | I | IRA | |
| Common StockF2 | holding | — | — | — | 274 | I | 401(k) Plan |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock Option (Right to Buy) | $18.85 | Sep 22, 2015 | M | 250 | D | Jan 18, 2007 | Jan 17, 2016 | Common | 250 | 0 | D |
| Stock Option (Right to Buy) | $18.85 | Sep 22, 2015 | M | 625 | D | Jan 18, 2008 | Jan 17, 2016 | Common | 625 | 0 | D |
| Stock Option (Right to Buy) | $18.85 | Sep 22, 2015 | M | 625 | D | Jan 18, 2009 | Jan 17, 2016 | Common | 625 | 0 | D |
Explanation of responses
- F1Shares are held in a self-directed IRA account.
- F2The number of shares in column 5 is the reporting person's best estimate based on a plan statement dated December 31, 2014.