0000905729-19-000002.txt : 20190104 0000905729-19-000002.hdr.sgml : 20190104 20190104170104 ACCESSION NUMBER: 0000905729-19-000002 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20190102 FILED AS OF DATE: 20190104 DATE AS OF CHANGE: 20190104 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Clark Sheila R CENTRAL INDEX KEY: 0001380755 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-19202 FILM NUMBER: 19510899 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 ownership.xml X0306 4 2019-01-02 1 0000803164 CHOICEONE FINANCIAL SERVICES INC NONE 0001380755 Clark Sheila R 109 EAST DIVISION SPARTA MI 49345 0 1 0 0 S.V.P. - ChoiceOne Bank (Sub.) Common Stock 21395.8189 D Common Stock 5576.39 I 401(k) Plan Column 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. /s/ Thomas L. Lampen, by Power of Attorney 2019-01-04 EX-24 2 clarkpoa.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 28     , 2015 /s/ Sheila R. Clark
  (signature)
   
   
  Sheila R. Clark
  (type or print name)