0001209191-19-006666.txt : 20190204
0001209191-19-006666.hdr.sgml : 20190204
20190204120028
ACCESSION NUMBER: 0001209191-19-006666
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20190201
FILED AS OF DATE: 20190204
DATE AS OF CHANGE: 20190204
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: SIEBENMORGEN PAUL S
CENTRAL INDEX KEY: 0001199382
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38084
FILM NUMBER: 19562659
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
2019-02-01
0
0000792966
FARMERS & MERCHANTS BANCORP INC
FMAO
0001199382
SIEBENMORGEN PAUL S
405 QUAIL RUN
ARCHBOLD
OH
43502
1
1
0
0
President & CEO
COMMON
46077
D
COMMON
2019-02-01
4
F
0
12000
31.53
D
40430
D
COMMON
2019-12-19
4
J
0
1142
0.00
A
41572
I
Mother's Trust
12,000 shares representing restricted stock awards issued pursuant to the Company's Long Term Incentive Plan were vested by Mr. Siebenmorgen due to his retirement from the "Company".
5,647 shares were repurchased by the "Company" to cover taxation. The "Company" calculated taxes owed - federal, state, and local on 5,647 shares that were vested on 2/1/2019 as a result of stock awards issued pursuant to the Company's Long Term Incentive plan.
Shares are attributable to Paul S. Siebenmorgen being appointed trustee of his mother's trust who is deceased.
/s/ Paul S. Siebenmorgen
2019-02-04