0000892712-12-000092.txt : 20120224 0000892712-12-000092.hdr.sgml : 20120224 20120224181233 ACCESSION NUMBER: 0000892712-12-000092 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20120222 FILED AS OF DATE: 20120224 DATE AS OF CHANGE: 20120224 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ROGGE JEFFREY S. CENTRAL INDEX KEY: 0001518608 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-54299 FILM NUMBER: 12639558 MAIL ADDRESS: STREET 1: C/O CHOICE BANCORP, INC. STREET 2: 2450 WITZEL AVENUE CITY: OSHKOSH STATE: WI ZIP: 54904 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: CHOICE BANCORP, INC. CENTRAL INDEX KEY: 0001487623 STANDARD INDUSTRIAL CLASSIFICATION: STATE COMMERCIAL BANKS [6022] IRS NUMBER: 000000000 STATE OF INCORPORATION: WI FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 2450 WITZEL AVENUE CITY: OSHKOSH STATE: WI ZIP: 54904 BUSINESS PHONE: (920) 230-1300 MAIL ADDRESS: STREET 1: 2450 WITZEL AVENUE CITY: OSHKOSH STATE: WI ZIP: 54904 4 1 edgar.xml PRIMARY DOCUMENT X0304 4 2012-02-22 0001487623 CHOICE BANCORP, INC. CBKW 0001518608 ROGGE JEFFREY S. 2450 WITZEL AVENUE OSHKOSH WI 54904 1 0 0 0 Common Stock 2012-02-22 4 P 0 250 10.00 A 25750 D Common Stock 500 I By spouse Shareholder Warrants (Right to Buy) 12.50 2012-02-22 4 P 0 50 0 A 2011-03-10 2012-07-24 Common Stock 50 5150 D Employee Stock Option (Right to Buy) 6.60 2011-12-05 4 A 0 2500 0 A 2011-12-05 2021-12-05 Common Stock 2500 2500 D Organizer Warrants (Right to Buy) 10.00 2011-03-10 2016-07-24 Common Stock 11250 11250 D Shareholder Warrants (Right to Buy) 12.50 2011-03-10 2012-07-24 Common Stock 100 100 I By Spouse Warrants issued in conjunction with a reorganization in exchange for previously exercisable warrants issued by Choice Bank. John F. Glynn (pursuant to Power of Attorney filed herewith) 2012-02-24 EX-24 2 roggepoa.htm POWER OF ATTORNEY

POWER OF ATTORNEY

For Executing Forms 3, 4 and 5 and 144


Know all by these present, that the undersigned constitutes and appoints each of Stanley G. Leedle and John F. Glynn, signing singly, his true and lawful attorney-in-fact to:


 

(1)

execute for and on behalf of the undersigned Forms 3, 4 and 5 in accordance with Section 16(a) of the Securities Exchange Act of 1934 and the rules thereunder;

 

 

 

 

(2)

execute for and on behalf of the undersigned notices on Form 144 in accordance with Rule 144 under the Securities Act of 1933;

 

 

 

 

(3)

do and perform any and all acts for and on behalf of the undersigned which may be necessary or desirable to complete the execution of any such Forms 3, 4 or 5 or Form 144 and the timely filing of such forms with the United States Securities and Exchange Commission, any stock exchange or other authority; and

 

 

 

 

(4)

take any other action of any type whatsoever in connection with the foregoing which, in the opinion of such attorney-in-fact, may be of benefit to, in the best interest of, or legally required by, the undersigned, it being understood that the documents executed by such attorney-in-fact on behalf of the undersigned pursuant to the Power of Attorney shall be in such form and shall contain such terms and conditions as such attorney-in-fact may approve in his or her discretion.


The undersigned hereby grants to each such attorney-in-fact full power and authority to do and perform all and every act and thing whatsoever requisite, necessary and proper to be done in the exercise of any of the rights and powers herein granted, as fully to all intents and purposes, as the undersigned might or could do if personally present, with full power of substitution or revocation and hereby ratifies and confirms all that such attorney-in-fact shall lawfully do or cause to be done by virtue of this power of attorney and the rights and powers herein granted.  The undersigned acknowledges that the foregoing attorneys-in-fact, in serving in such capacity at the request of the undersigned, are not assuming any of the undersigned’s responsibilities to comply with Section 16 of the Securities Exchange Act of 1934 and the rules thereunder or Rule 144 under the Securities Act of 1933.  This Power of Attorney shall be a durable power of attorney and shall not be affected by subsequent disability or incapacity of the undersigned.


IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be executed as of this 14th day of April, 2011.



Signature:

/s/ Jeffrey S. Rogge                         

Type or Print Name:

Jeffrey S. Rogge