SEC Form 4 · accession 0000905729-17-000237
CHOICEONE FINANCIAL SERVICES INC · COFS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Nels W Nyblad
Director
Period of report
Jul 26, 2017
Accepted (ET)
Jul 26, 2017 · 5:22 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 StockF1 | Jul 26, 2017 | A | 182 | $22.65 | A | 11,887 | I | Reporting person's trust |
| Common StockF1 | holding | — | — | — | 2,413 | D | ||
| Common StockF1 | holding | — | — | — | 1,260 | I | By IRA | |
| Common StockF1 | holding | — | — | — | 16,220 | I | By spouse's trust | |
| Common StockF1 | holding | — | — | — | 157 | I | By spouse's IRA | |
| Common StockF2,F1 | holding | — | — | — | 161 | I | By wife as UTMA custodian for daughters |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1On April 27, 2017, ChoiceOne Financial Services, Inc. announced a 5% stock dividend, payable to all holders of record as of May 10, 2017. As a result, the reporting person received 1,500 shares of common stock as of May 31, 2017, of which 540 shares are owned indirectly through the reporting person's trust, 114 shares are owned directly, 60 shares are owned indirectly through the reporting person's IRA, and 786 are owned by reporting person's wife and by wife as custodian for daughters.
- F2Shares held by wife for children under the Uniform Transfers to Minors Act. The reporting person disclaims beneficial ownership of these shares, and this report shall not be deemed an admission that the reporting person owns the shares for the purposes of Section 16 or any other purpose