0000899243-17-024559.txt : 20171023
0000899243-17-024559.hdr.sgml : 20171023
20171023160117
ACCESSION NUMBER: 0000899243-17-024559
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20121214
FILED AS OF DATE: 20171023
DATE AS OF CHANGE: 20171023
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Burkholder Eugene N
CENTRAL INDEX KEY: 0001542390
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38084
FILM NUMBER: 171149049
MAIL ADDRESS:
STREET 1: 12730 US HIGHWAY 20A
CITY: WAUSEON
STATE: OH
ZIP: 43567
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: FARMERS & MERCHANTS BANCORP INC
CENTRAL INDEX KEY: 0000792966
STANDARD INDUSTRIAL CLASSIFICATION: SAVINGS INSTITUTION, FEDERALLY CHARTERED [6035]
IRS NUMBER: 341469491
STATE OF INCORPORATION: OH
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 307-11 N DEFIANCE ST
CITY: ARCHBOLD
STATE: OH
ZIP: 43502
BUSINESS PHONE: 4194462501
MAIL ADDRESS:
STREET 1: 307-11 NORTH DEFIANCE ST
CITY: ARCHBOLD
STATE: OH
ZIP: 43502
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2012-12-14
0
0000792966
FARMERS & MERCHANTS BANCORP INC
FMAO
0001542390
Burkholder Eugene N
12730 US HIGHWAY 20A
WAUSEON
OH
43567
1
0
0
0
Common stock
2012-12-14
4
G
0
2500
0.00
D
5240
I
By Trust
Common stock
2012-12-14
4
G
0
2500
0.00
A
2500
I
by spouse trust
Common stock
2013-05-06
4
P
0
717
21.90
A
5957
I
By Trust
Common stock
2013-05-06
4
P
0
716
21.90
A
3216
I
by spouse trust
/s/ Eugene N. Burkholder
2017-07-10