-----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, Vhro3jx3mT/h0vLb5NZLdk8iXG6Z77dR7rVS1m9qLD6dD/+FWMO9WyFgxK8qX3Xd VrGBDEUCB6a2hp+3dWUDFw== 0000700565-03-000198.txt : 20031001 0000700565-03-000198.hdr.sgml : 20031001 20031001104631 ACCESSION NUMBER: 0000700565-03-000198 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20030930 FILED AS OF DATE: 20031001 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: MELVIN GARY W CENTRAL INDEX KEY: 0001185506 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-13368 FILM NUMBER: 03919327 BUSINESS ADDRESS: STREET 1: 4216 DEWITT AVE CITY: MATTOON STATE: IL ZIP: 61938 BUSINESS PHONE: 2172357101 MAIL ADDRESS: STREET 1: RR1, BOX 226 CITY: SULLIVAN STATE: IL ZIP: 61951 4 1 form4_melvin-100103ex.xml X0201 4 2003-09-30 0 0000700565 FIRST MID ILLINOIS BANCSHARES INC fmbh.ob 0001185506 MELVIN GARY W 4216 DEWITT AVE MATTOON IL 61938 1 0 0 0 Common Stock 98205 D Common Stock 2003-09-30 4 P 0 161.089 34.00 A 15050.794 I By Deferred COmp Stock Option 15.67 1997-10-21 2007-10-21 Common Stock 750 750 D Stock Option 22.49 1997-12-15 2008-01-12 Common Stock 750 1500 D Stock Option 23.33 1998-12-15 2008-12-22 Common Stock 750 2250 D Stock Option 23.00 1999-12-13 2009-12-13 Common Stock 750 3000 D Stock Option 18.83 2000-12-18 2010-12-18 Common Stock 750 3750 D Stock Option 24.00 2001-12-18 2011-12-18 Common Stock 1000 4750 D Stock Option 27.25 2002-12-16 2012-12-16 Common Stock 1000 5750 D Michael L. Taylor, pursuant to a power of attorney 11/1/02 2003-10-01 -----END PRIVACY-ENHANCED MESSAGE-----