SEC Form 4 · accession 0001209191-19-006666
FARMERS & MERCHANTS BANCORP INC · FMAO
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Paul S Siebenmorgen
Officer — President & CEO · Director
Period of report
Feb 1, 2019
Accepted (ET)
Feb 4, 2019 · 12:00 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000792966
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| COMMONF2 | Feb 1, 2019 | F | 12,000 | $31.53 | D | 40,430 | D | |
| COMMON | Dec 19, 2019 | J | 1,142 | $0.00 | A | 41,572 | I | Mother's Trust |
| COMMONF1 | holding | — | — | — | 46,077 | D |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F112,000 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".
- F25,647 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.
- F3Shares are attributable to Paul S. Siebenmorgen being appointed trustee of his mother's trust who is deceased.