0001567619-21-017023.txt : 20210913 0001567619-21-017023.hdr.sgml : 20210913 20210913175444 ACCESSION NUMBER: 0001567619-21-017023 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210913 FILED AS OF DATE: 20210913 DATE AS OF CHANGE: 20210913 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Montgomery John Haines CENTRAL INDEX KEY: 0001437134 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36706 FILM NUMBER: 211250640 MAIL ADDRESS: STREET 1: 100 NORTH MARKET STREET CITY: CARMICHAELS STATE: PA ZIP: 15320 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: CB Financial Services, Inc. CENTRAL INDEX KEY: 0001605301 STANDARD INDUSTRIAL CLASSIFICATION: STATE COMMERCIAL BANKS [6022] IRS NUMBER: 000000000 STATE OF INCORPORATION: PA FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 100 NORTH MARKET STREET CITY: CARMICHAELS STATE: PA ZIP: 15320 BUSINESS PHONE: 724-966-5041 MAIL ADDRESS: STREET 1: 100 NORTH MARKET STREET CITY: CARMICHAELS STATE: PA ZIP: 15320 4 1 doc1.xml FORM 4 X0306 4 2021-09-13 0 0001605301 CB Financial Services, Inc. CBFV 0001437134 Montgomery John Haines 100 N. MARKET STREET CARMICHAELS PA 15320 1 1 0 0 President and CEO Common Stock 2021-09-13 4 M 0 3000 18.60 A 12600 D Common Stock 2500 I By IRA Stock Options 18.60 2021-09-13 4 M 0 3000 0.00 D 2021-08-31 2030-08-31 Common Stock 3000 12000 D Includes shares of restricted stock which vest at a rate of 20% per year commencing on December 14, 2021. Includes shares of restricted stock which vest at a rate of 20% per year commencing on August 31, 2021. Stock options vest at a rate of 20% per year commencing on August 31, 2021. /s/ Daniel Lutz, pursuant to power of attorney 2021-09-13