0001209191-17-037689.txt : 20170605 0001209191-17-037689.hdr.sgml : 20170605 20170605161647 ACCESSION NUMBER: 0001209191-17-037689 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170605 FILED AS OF DATE: 20170605 DATE AS OF CHANGE: 20170605 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 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: 17891341 MAIL ADDRESS: STREET 1: 12730 US HIGHWAY 20A CITY: WAUSEON STATE: OH ZIP: 43567 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 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 2017-06-05 4 S 0 1000 55.75 D 11529 D COMMON 2017-06-05 4 S 0 571 55.75 D 10958 I Spouse by Trust Eugene N Burkholder Trust/Eugene N Burkholder TTEE Shannon L Burkholder Trust / Shannon L Burkholder TTEE Lydia Huber 2017-06-05