SEC Form 4 · accession 0000905729-15-000325
CHOICEONE FINANCIAL SERVICES INC · COFS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Thomas L Lampen
Officer — Treasurer
Period of report
Aug 3, 2015
Accepted (ET)
Nov 20, 2015 · 5:07 pm EST
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 StockF1,F2 | Aug 3, 2015 | F | 62 | $22.75 | D | 7,809 | D | |
| Common Stock | Nov 19, 2015 | M | 500 | $18.85 | A | 8,309 | D | |
| Common Stock | Nov 19, 2015 | F | 387 | $24.37 | D | 7,922 | D | |
| Common StockF3 | holding | — | — | — | 1,459 | 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 | Nov 19, 2015 | M | 125 | D | Jan 18, 2006 | Jan 18, 2016 | Common | 125 | 0 | D |
| Stock Option (Right to Buy) | $18.85 | Nov 19, 2015 | M | 125 | D | Jan 18, 2007 | Jan 18, 2016 | Common | 125 | 0 | D |
| Stock Option (Right to Buy) | $18.85 | Nov 19, 2015 | M | 125 | D | Jan 18, 2008 | Jan 18, 2016 | Common | 125 | 0 | D |
| Stock Option (Right to Buy) | $18.85 | Nov 19, 2015 | M | 125 | D | Jan 18, 2009 | Jan 28, 2016 | Common | 125 | 0 | D |
Explanation of responses
- F1Shares forfeited upon conversion of stock units granted on August 1, 2014 to common stock.
- F2Column 5 reflects the acquisition of 164.7027 shares under the ChoiceOne Financial Services, Inc. Employee Stock Purchase Plan and 95.9901 shares from the reinvestment of cash dividends.
- F3The number of shares in column 5 is the reporting person's best estimate based on a plan statement dated December 31, 2014.