-----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, CVJWUHgPzxbLVj+cG6c4KdAbwmDwleDv0QI7sBaacAn8A20fioOkGqEbKUfoVw7o 1GkcY9P5Y7idZI7BGKXO/g== 0000700565-03-000199.txt : 20031001 0000700565-03-000199.hdr.sgml : 20031001 20031001104754 ACCESSION NUMBER: 0000700565-03-000199 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: HEDGES JOHN W CENTRAL INDEX KEY: 0001185494 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-13368 FILM NUMBER: 03919333 BUSINESS ADDRESS: STREET 1: 1515 CHARLESTON AVE CITY: MATTOON STATE: IL ZIP: 61938 BUSINESS PHONE: 2172580670 MAIL ADDRESS: STREET 1: 4 PINEHURST DRIVE CITY: MATTOON STATE: IL ZIP: 61938 4 1 form4_hedges-100103ex.xml X0201 4 2003-09-30 0 0000700565 FIRST MID ILLINOIS BANCSHARES INC fmbh.ob 0001185494 HEDGES JOHN W 1515 CHARLESTON AVE MATTOON IL 61938 0 1 0 0 Pres First Mid-Illinois Bank Common Stock 250 D Common Stock 27.733 I By 401K Common Stock 2003-09-30 4 P 0 .86 34.00 A 1114.388 I By Deferred Comp Stock Option 23.00 2001-01-01 2009-12-13 Common Stock 3000 3000 D Stock Option 18.83 2002-01-01 2010-12-18 Common Stock 2250 5250 D Stock Option 24.00 2003-01-01 2011-12-18 Common Stock 2250 7500 D Stock Option 27.25 2004-01-01 2002-12-16 Common Stock 3250 10750 D Options become exerciseable in 4 equal annual installments beginning on 1/1/2001 Options become exerciseable in 4 equal annual installments beginning on 1/1/2002 Options become exerciseable in 4 equal annual installments beginning on 1/1/2003 Options become exerciseable in 4 equal annual installments beginning on 1/1/2004 Michael L. Taylor, pursuant to a power of attorney filed 11/01/2002 2003-10-01 -----END PRIVACY-ENHANCED MESSAGE-----