0000899243-17-024563.txt : 20171023 0000899243-17-024563.hdr.sgml : 20171023 20171023160422 ACCESSION NUMBER: 0000899243-17-024563 CONFORMED SUBMISSION TYPE: 4/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170530 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/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-38084 FILM NUMBER: 171149070 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/A 1 doc4a.xml FORM 4/A SUBMISSION X0306 4/A 2017-05-30 2017-06-05 0 0000792966 FARMERS & MERCHANTS BANCORP INC FMAO 0001542390 Burkholder Eugene N 12730 US HIGHWAY 20A WAUSEON OH 43567 1 0 0 0 Common stock 2017-05-30 4 S 0 129 58.00 D 8694 I By Trust Common stock 2017-06-01 4 S 0 815 55.00 D 7879 I By Trust Common stock 2017-06-02 4 S 0 185 55.00 D 7694 I By Trust Common stock 2017-06-05 4 S 0 1000 55.75 D 6694 I By Trust Common Stock 4322 I by spouse trust All transactions inadvertently reported as being dispositions of directly held shares. /s/ Eugene N. Burkholder 2017-07-10