SEC Form 4 · accession 0000905729-15-000326
CHOICEONE FINANCIAL SERVICES INC · COFS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Sheila R Clark
Officer — Sr V.P. - ChoiceOne Bank (Sub)
Period of report
Nov 19, 2015
Accepted (ET)
Nov 20, 2015 · 5:08 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 | Nov 19, 2015 | M | 1,000 | $13.50 | A | 18,273 | D | |
| Common Stock | Nov 19, 2015 | F | 554 | $24.37 | D | 17,719 | D | |
| Common StockF1 | holding | — | — | — | 5,058 | 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) | $13.50 | Nov 19, 2015 | M | 250 | D | Jan 24, 2008 | Jan 23, 2018 | Common | 250 | 0 | D |
| Stock Option (Right to Buy) | $13.50 | Nov 19, 2015 | M | 250 | D | Jan 24, 2009 | Jan 23, 2018 | Common | 250 | 0 | D |
| Stock Option (Right to Buy) | $13.50 | Nov 19, 2015 | M | 250 | D | Jan 24, 2010 | Jan 23, 2018 | Common | 250 | 0 | D |
| Stock Option (Right to Buy) | $13.50 | Nov 19, 2015 | M | 250 | D | Jan 24, 2011 | Jan 23, 2018 | Common | 250 | 0 | D |
Explanation of responses
- F1The number of shares in column 5 is the reporting person's best estimate based on a plan statement dated December 31, 2014.