SEC Form 4 · accession 0000905729-15-000350
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
Dec 16, 2015
Accepted (ET)
Dec 18, 2015 · 2:03 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 | holding | — | — | — | 8,056 | I | IRA | |
| Common Stock | holding | — | — | — | 12,531 | D | ||
| 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) | $23.30 | Dec 16, 2015 | A | 2,000 | A | Dec 16, 2015 | Dec 16, 2025 | Common | 2,000 | 2,000 | D |
| Stock Option (Right to Buy) | $23.30 | Dec 16, 2015 | A | 2,000 | A | Dec 16, 2016 | Dec 16, 2025 | Common | 2,000 | 2,000 | D |
| Stock Option (Right to Buy) | $23.30 | Dec 16, 2015 | A | 2,000 | A | Dec 16, 2017 | Dec 16, 2025 | Common | 2,000 | 2,000 | D |
| Stock Option (Right to Buy) | $23.30 | Dec 16, 2015 | A | 2,000 | A | Dec 16, 2018 | Dec 16, 2025 | Common | 2,000 | 2,000 | 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.