SEC Form 4/A · accession 0000905729-19-000008
CHOICEONE FINANCIAL SERVICES INC · COFS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
This is an amendment (Form 4/A). It replaces an earlier filing for the same period.
Reporting owner
Sheila R Clark
Officer — S.V.P. - ChoiceOne Bank (Sub.)
Period of report
Jan 2, 2019
Accepted (ET)
Jan 8, 2019 · 12:34 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,F2 | Jan 2, 2019 | F | 413 | $25.00 | D | 20,986 | D | |
| Common Stock | holding | — | — | — | 5,576 | I | 401(k) Plan |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1Amended Form 4 filed to reflect transaction erroneously omitted from Form 4 as originally filed, in which shares were forfeited upon conversion of stock units granted on April 15, 2016, April 15, 2017, and April 15, 2018 to common stock.
- F2Column 5 reflects the acquisition of 99.7301 shares under the ChoiceOne Financial Services, Inc. Employee Stock Purchase Plan and 130.0888 shares from the reinvestment of cash dividends.