-----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, HyLQCrqAREwtY6TAjWiO8ob3tTnVn0NV9modfWUOLeY37dsjZZ+VanEzOgILxubR jIHmO+PjKFdeG1nkunj6gA== 0000700565-04-000016.txt : 20040102 0000700565-04-000016.hdr.sgml : 20040101 20040102104618 ACCESSION NUMBER: 0000700565-04-000016 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20031231 FILED AS OF DATE: 20040102 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: SPARKS RAY A CENTRAL INDEX KEY: 0001012163 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-13368 FILM NUMBER: 04500343 BUSINESS ADDRESS: STREET 1: 30 S COUNTY CLUB ROAD CITY: MATTOON STATE: IL ZIP: 61938 BUSINESS PHONE: 2172588741 MAIL ADDRESS: STREET 1: 30 S COUNTRY CLUB RD CITY: MATTOON STATE: IL ZIP: 61938 4 1 form4_sparks-123103ex.xml X0201 4 2003-12-31 0 0000700565 FIRST MID ILLINOIS BANCSHARES INC fmbh.ob 0001012163 SPARKS RAY A 30 S COUNTY CLUB ROAD MATTOON IL 61938 1 0 0 0 Common Stock 3763.118 I By Wife Common Stock 37878.661 I By Sparks Investment Group Common Stock 71165.812 D Common Stock 2003-12-31 4 P 0 154.269 46.90 A 6985.035 I By Deferred Comp Stock Option 46.50 2003-12-16 2013-12-16 Common Stock 1500 1500 D Michael L. Taylor, pursuant to a power of attorney filed 09/06/2002 2004-01-02 -----END PRIVACY-ENHANCED MESSAGE-----