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