-----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, GxGsn840p6l3HSmF9DjWzs3I/hzJjqKN8r8CPJNtxyEZDdPwNGSFCkFV7dyL3C5s 8nT08bo8l8M/sYaGA64tXw== 0000700565-03-000206.txt : 20031112 0000700565-03-000206.hdr.sgml : 20031112 20031112153052 ACCESSION NUMBER: 0000700565-03-000206 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20031110 FILED AS OF DATE: 20031112 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: MARVIN DANIEL E JR CENTRAL INDEX KEY: 0001186266 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-13368 FILM NUMBER: 03993492 BUSINESS ADDRESS: STREET 1: 12 ST ANDREWS PLACE CITY: MATTOON STATE: IL ZIP: 61938 BUSINESS PHONE: 2172352015 MAIL ADDRESS: STREET 1: 12 ST ANDREWS PLACE CITY: MATTOON STATE: IL ZIP: 61938 4 1 form4_marvin-111203ex.xml X0201 4 2003-11-10 0 0000700565 FIRST MID ILLINOIS BANCSHARES INC fmbh.ob 0001186266 MARVIN DANIEL E JR 12 ST ANDREWS PLACE MATTOON IL 61938 1 0 0 0 Common Stock 1310.376 I Cust for minor grandchildren Common Stock 15755.682 I By IRA Common Stock 4502.783 I By Deferred Comp Common Stock 2003-11-10 5 G 0 12144 A 14609 I By Wife Common Stock 2003-11-10 5 G 0 12144 D 13088 D Stock Options 15.67 1998-10-21 2007-10-21 Common Stock 6000 6000 D Stock Options 22.49 1999-10-01 2008-01-12 Common Stock 3750 9750 D Stock Options 23.33 2000-01-01 2008-12-22 Common Stock 3750 13500 D Stock Options 23 1999-12-13 2009-12-13 Common Stock 750 14250 D Stock Options 18.83 2000-12-18 2010-12-18 Common Stock 750 15000 D Stock Options 24 2001-12-18 2011-12-18 Common Stock 1000 16000 D Stock Options 27.25 2002-12-16 2012-12-16 Common Stock 1000 17000 D Options become exercisable in 4 equal annual installments beginning on 10/21/1998. Options become exercisable in 4 equal annual installments beginning on 1/1/1999. Options become exercisable in 4 equal annual installments beginning on 1/1/2000. On November 10, 2003 Mr. Marvin gifted 12,144 shares of First Mid-Illinois Bancshares Common Stock to his wife. Michael L. Taylor, pursuant to a power of attorney filed11/01/2002 2003-11-12 -----END PRIVACY-ENHANCED MESSAGE-----