UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 15
CERTIFICATION AND NOTICE OF TERMINATION OF REGISTRATION UNDER
SECTION 12(g) OF THE SECURITIES EXCHANGE ACT OF 1934 OR SUSPENSION
OF DUTY TO FILE REPORTS UNDER SECTIONS 13 AND 15(d) OF THE
SECURITIES EXCHANGE ACT OF 1934.
Commission File Number 001-38084
The Farmers & Merchants State Bank
401(k) Profit Sharing Plan
(Exact name of registrant as specified in its charter)
Farmers & Merchants State Bank
307 North Defiance Street
Archbold, Ohio 43502
(419) 446-2501
(Address, including zip code, and telephone number, including area code, of registrant’s principal executive offices)
Plan Interests in the
Farmers & Merchants State Bank 401(k) Profit Sharing Plan
(Title of each class of securities covered by this Form)
Farmers &
Merchants Bancorp, Inc. Common Stock, no par value per share(1)
(Titles of all other classes of securities for which a duty to file reports under section 13(a) or 15(d) remains)
Please place an X in the box(es) to designate the appropriate rule provision(s) relied upon to terminate or suspend the duty to file reports:
| Rule 12g-4(a)(1) | ¨ | ||
| Rule 12g-4(a)(2) | ¨ | ||
| Rule 12h-3(b)(1)(i) | x | ||
| Rule 12h-3(b)(1)(ii) | ¨ | ||
| Rule 15d-6 | ¨ |
Approximate number of holders of record as of the certification or notice date: None(2)
| (1) | Although the duty to file reports under Section 13(a) or 15(d) of the Securities Exchange Act of 1934, as amended, has been terminated with respect to the Farmers & Merchants State Bank 401(k) Profit Sharing Plan (the “Plan”), the duty to file reports under Section 13(a) or 15(d) remains with respect to Farmers & Merchants Bancorp, Inc. common stock, no par value per share (the “Common Stock”). |
| (2) | The Plan no longer offers Common Stock as an investment option. Therefore, interests in the Plan no longer require registration. Accordingly, this Form 15 is being filed solely to suspend the Plan’s duty to file reports under Section 15(d), including on Form 11-K. |
Pursuant to the requirements of the Securities Exchange Act of 1934, the Farmers & Merchants State Bank 401(k) Profit Sharing Plan has caused this certification/notice to be signed on its behalf by the undersigned duly authorized person.
| Date: September 27, 2024 | Farmers & Merchants State Bank 401(k) Profit Sharing Plan | |||
| By: | The Farmers & Merchants State Bank | |||
| By: | /s/ Lars B. Eller | |||
| Lars B. Eller | ||||
| President and CEO | ||||