-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, VtPvrPCfMfekrG9HzcKadHP/a/RxOBZqiA5TpiINfLitT8GFzIFzfYh+IxHbaNaH PT6eZSkjltdRdYpzf4hRQQ== 0000700565-03-000192.txt : 20030926 0000700565-03-000192.hdr.sgml : 20030926 20030926114212 ACCESSION NUMBER: 0000700565-03-000192 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20030808 FILED AS OF DATE: 20030926 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: FIRST MID ILLINOIS BANCSHARES INC CENTRAL INDEX KEY: 0000700565 STANDARD INDUSTRIAL CLASSIFICATION: STATE COMMERCIAL BANKS [6022] IRS NUMBER: 371103704 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1515 CHARLESTON AVE STREET 2: PO BOX 499 CITY: MATTOON STATE: IL ZIP: 61938 BUSINESS PHONE: 2172347454 MAIL ADDRESS: STREET 1: 1515 CHARLESTON AVENUE STREET 2: PO BOX 499 CITY: MATTOON STATE: IL ZIP: 61938 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BURICH CHRISTIE L CENTRAL INDEX KEY: 0001185503 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-13368 FILM NUMBER: 03911486 BUSINESS ADDRESS: STREET 1: 1515 CHARLESTON AVE CITY: MATTOON STATE: IL ZIP: 61938 BUSINESS PHONE: 2172580493 MAIL ADDRESS: STREET 1: 11 OAK POINTE DRIVE CITY: NEOGA STATE: IL ZIP: 62447 4 1 form4_burich-092603ex.xml X0201 4 2003-08-08 0 0000700565 FIRST MID ILLINOIS BANCSHARES INC fmbh.ob 0001185503 BURICH CHRISTIE L 1515 CHARLESTON AVE MATTOON IL 61938 0 1 0 0 Vice President/Secretary Common Stock 378.211 D Common Stock 1681.368 I By Spouse Common Stock 1528.668 I By 401K Stock Option 24 2003-01-01 2011-12-18 Common Stock 1125 1125 D Stock Option 27.25 2004-01-01 2012-12-16 Common Stock 1500 2625 D The reporting person acquired beneficial ownership of these shares upon her marriage to the owner ot the shares on August 8, 2003. Options become exercisable in 4 equal annual installments beginning 1/1/2003. Options become exercisable in 4 equal annual installments beginning 1/1/2004. Christie L Burich 2003-09-26 -----END PRIVACY-ENHANCED MESSAGE-----