0001209191-20-017591.txt : 20200310
0001209191-20-017591.hdr.sgml : 20200310
20200310125635
ACCESSION NUMBER: 0001209191-20-017591
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20200310
FILED AS OF DATE: 20200310
DATE AS OF CHANGE: 20200310
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: 20700742
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
2020-03-10
0
0000792966
FARMERS & MERCHANTS BANCORP INC
FMAO
0001542390
Burkholder Eugene N
12730 US HIGHWAY 20A
WAUSEON
OH
43567
1
0
0
0
COMMON
8644
I
By Trust
COMMON
13323
I
By Trust
COMMON
2020-03-10
2020-03-10
4
P
0
2000
21.49
A
23967
I
By Trust
Shares reflect a 2 for 1 split of the Issuer's Common Stock which became effective on 9/20/17
8,644 FMAO shares of common stock owned in a trust of which Mr. Burkholder has been assigned as the trustee.
Shares reflect a 2 for 1 split of the Issuer's Common Stock which became effective on 9/20/17.
Shares also reflect the Dividend Reinvestment Plan of the Issuer's Common Stock which were credited to the reporting individual
Eugene N Burkholder Trust/Eugene N Burkholder TTEE
Eugene N Burkholder Trust/Eugene N Burkholder TTEE
/s/ Eugene N Burkholder
2020-03-10