0000905729-18-000123.txt : 20180605 0000905729-18-000123.hdr.sgml : 20180605 20180605152021 ACCESSION NUMBER: 0000905729-18-000123 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20180601 FILED AS OF DATE: 20180605 DATE AS OF CHANGE: 20180605 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: POTES KELLY CENTRAL INDEX KEY: 0001201748 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-19202 FILM NUMBER: 18880938 MAIL ADDRESS: STREET 1: 109 EAST DIVISION STREET CITY: SPARTA STATE: MI ZIP: 49345 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: CHOICEONE FINANCIAL SERVICES INC CENTRAL INDEX KEY: 0000803164 STANDARD INDUSTRIAL CLASSIFICATION: STATE COMMERCIAL BANKS [6022] IRS NUMBER: 382659066 STATE OF INCORPORATION: MI FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 109 E DIVISION STREET 2: P O BOX 186 CITY: SPARTA STATE: MI ZIP: 49345-0186 BUSINESS PHONE: 6168877366 MAIL ADDRESS: STREET 1: 109 EAST DIVISION STREET 2: P O BOX 186 CITY: SPARTA STATE: MI ZIP: 49345-0186 FORMER COMPANY: FORMER CONFORMED NAME: 1ST COMMUNITY BANCORP INC DATE OF NAME CHANGE: 19920703 4 1 potes4_060518.xml OWNERSHIP DOCUMENT X0306 4 2018-06-01 0 0000803164 CHOICEONE FINANCIAL SERVICES INC NONE 0001201748 POTES KELLY 109 EAST DIVISION STREET SPARTA MI 49345 1 1 0 0 President Common stock 18491.4456 D Common stock 2643.8979 I IRA Common stock 540.9548 I 401(k) Plan Stock Option (Right to Buy) 25.65 2018-06-01 4 A 0 1500 0 A 2018-06-01 2028-05-31 Common 1500 1500 D Stock Option (Right to Buy) 25.65 2018-06-01 4 A 0 1500 0 A 2019-06-01 2028-05-31 Common 1500 1500 D Stock Option (Right to Buy) 25.65 2018-06-01 4 A 0 1500 0 A 2020-06-01 2028-05-31 Common 1500 1500 D Stock Option (Right to Buy) 25.65 2018-06-01 4 A 0 1500 0 A 2021-06-01 2028-05-31 Common 1500 1500 D On 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 1,029.8913 shares of common stock as of May 31, 2018, of which 879.1315 shares are owned directly, 125.0000 shares are owned indirectly through the reporting person's IRA and 25.7598 shares are owned indirectly through the reporting person's 401(k) plan. /s/ Thomas L. Lampen, by Power of Attorney 2018-06-05 EX-24 2 potespoa.htm LIMITED POWER OF ATTORNEY

EXHIBIT 24

LIMITED POWER OF ATTORNEY

The undersigned does hereby constitute and appoint JAMES A. BOSSERD, THOMAS LAMPEN, MARY J. JOHNSON, JEFFREY A. OTT, GORDON R. LEWIS, and G. CHARLES GOODE, or any one or more of them, his or her true and lawful attorneys and agents, with full power of substitution in the premises, to do any and all acts and things and to execute and file any and all instruments that such attorneys and agents, or any of them, may consider necessary or advisable to enable the undersigned (in his or her individual capacity or in a fiduciary or other capacity) to comply with the Securities Act of 1933, as amended (the "Securities Act"), and the Securities Exchange Act of 1934, as amended (the "Act"), and any requirements of the Securities and Exchange Commission in respect thereof, in connection with his or her intended sale of any security related to ChoiceOne Financial Services, Inc. (the "Company") pursuant to Rule 144 issued under the Securities Act and the preparation, execution and filing of any report or statement of beneficial ownership or changes in beneficial ownership of securities of the Company that the undersigned (in his or her individual capacity or in a fiduciary or other capacity) may be required to file pursuant to Sections 13 or 16 of the Act including, without limitation, full power and authority to sign the undersigned's name, in his or her individual capacity or in a fiduciary or other capacity, to any report, application or statement on Form ID, Forms 3, 4, 5 or 144, Schedules 13D or 13G, or to any amendments or any successor forms thereto, or any form or forms adopted by the Securities and Exchange Commission in lieu thereof or in addition thereto, hereby ratifying and confirming all that such attorneys and agents, or any of them, shall do or cause to be done by virtue hereof.

The undersigned agrees that some of the attorneys-in-fact named herein may act as legal counsel to the Company in connection with the securities matters addressed herein, and that such attorneys do not represent the undersigned in his or her personal capacity in connection with such matters. The undersigned agrees that the attorneys-in-fact named herein may rely entirely on information furnished orally or in writing by the undersigned to such attorneys-in-fact. The undersigned also agrees to indemnify and hold harmless the attorneys-in-fact against any losses, claims, damages or liabilities (or actions in respect thereof) that arise out of or are based upon any untrue statement or omission of necessary fact in the information provided by the undersigned to the attorneys-in-fact for purposes of executing, acknowledging, delivering or filing any such forms, or any amendments or any successor forms thereto, or any form or forms adopted by the Securities and Exchange Commission in lieu thereof or in addition thereto.

This authorization shall supersede all prior authorizations to act for the undersigned with respect to securities of the Company in these matters, which prior authorizations are hereby revoked, and shall survive the termination of the undersigned's status as a director and/or officer of the Company and remain in effect thereafter for so long as the undersigned (in his or her individual capacity or in a fiduciary or other capacity) is subject to Rule 144 with respect to securities of the Company or has any obligation under Section 16 of the Exchange Act with respect to securities of the Company.

Dated: January 23 , 2015	/s/ Kelly Potes
	(signature)


	Kelly Potes
	(type or print name)