SEC Form 4 · accession 0000905729-18-000118
CHOICEONE FINANCIAL SERVICES INC · COFS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Sheila R Clark
Officer — S.V.P. - ChoiceOne Bank (Sub.)
Period of report
Jun 1, 2018
Accepted (ET)
Jun 5, 2018 · 3:11 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 | holding | — | — | — | 21,166 | D | ||
| Common StockF1 | holding | — | — | — | 5,576 | 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) | $25.65 | Jun 1, 2018 | A | 375 | A | Jun 1, 2018 | May 31, 2028 | Common | 375 | 375 | D |
| Stock Option (Right to Buy) | $25.65 | Jun 1, 2018 | A | 375 | A | Jun 1, 2019 | May 31, 2028 | Common | 375 | 375 | D |
| Stock Option (Right to Buy) | $25.65 | Jun 1, 2018 | A | 375 | A | Jun 1, 2020 | May 31, 2028 | Common | 375 | 375 | D |
| Stock Option (Right to Buy) | $25.65 | Jun 1, 2018 | A | 375 | A | Jun 1, 2021 | May 31, 2028 | Common | 375 | 375 | D |
Explanation of responses
- F1On April 25, 2018, ChoiceOne Financial Services, Inc. announced a 5% stock dividend, payable to all holders of record as of May 10, 2018. As a result, the reporting person received 1,269.44 shares of common stock as of May 31, 2018, of which 1,004.00 shares are owned directly and 265.44 shares are owned indirectly through the reporting person's 401(k) plan.