SEC Form 4 · accession 0000905729-16-000778
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
Dec 16, 2016
Accepted (ET)
Dec 20, 2016 · 11:25 am 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 | Dec 16, 2016 | M | 1,000 | $17.95 | A | 9,790 | D | |
| Common Stock | Dec 16, 2016 | F | 748 | $24.00 | D | 9,042 | D | |
| Common StockF2 | 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) | $17.95 | Dec 16, 2016 | M | 250 | D | Jan 18, 2007 | Jan 17, 2017 | Common | 250 | 0 | D |
| Stock Option (Right to Buy) | $17.95 | Dec 16, 2016 | M | 250 | D | Jan 18, 2008 | Jan 17, 2017 | Common | 250 | 0 | D |
| Stock Option (Right to Buy) | $17.95 | Dec 16, 2016 | M | 250 | D | Jan 18, 2009 | Jan 17, 2017 | Common | 250 | 0 | D |
| Stock Option (Right to Buy) | $17.95 | Dec 16, 2016 | M | 250 | D | Jan 18, 2010 | Jan 17, 2017 | Common | 250 | 0 | D |
Explanation of responses
- F1Column 5 reflects the acquisition of 56.8332 shares from the reinvestment of cash dividends and 47.8978 shares under the ChoiceOne Financial Services, Inc. Employee Stock Purchase Plan.
- F2The number of shares in column 5 is the reporting person's best estimate based on a plan statement dated December 31, 2015.