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 333-68479
FARMERS STATE BANCSHARES, INC.
(Exact name of registrant as specified in its charter)
1606 Commercial Street, Bangor, Wisconsin 54614-4469
(608) 486-2356
(Address, including zip code, and telephone number, including area code,
of registrant's principal executive offices)
Common Stock
(Title of each class of securities covered by this Form)
(None)
(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)(i) |_| Rule 12h-3(b)(1)(ii) |_|
Rule 12g-4(a)(1)(ii) |_| Rule 12h-3(b)(2)(i) |_|
Rule 12g-4(a)(2)(i) |_| Rule 12h-3(b)(2)(ii) |_|
Rule 12g-4(a)(2)(ii) |_| Rule 15d-6 |_|
Rule 12h-3(b)(1)(i) |X|
Approximate number of holders of record as of the
certification or notice date: 86
Pursuant to the requirements of the Securities Exchange Act of 1934,
Farmers State Bancshares, Inc. has caused this certification/notice to be signed
on its behalf by the undersigned duly authorized person.
DATE: September 10, 1999 BY: /s/ Kirsten E. Spira
Kirsten E. Spira
Counsel to the Registrant
