-----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, VjxnpPw465pbKaWAhPIdeKlKOO1bpqZUjm6w3c2IakOqDGYGASWWOyYS6VFA9E7W 2PnX9nd3FSfljAfyxHHhHA== 0000700565-04-000026.txt : 20040206 0000700565-04-000026.hdr.sgml : 20040206 20040206163232 ACCESSION NUMBER: 0000700565-04-000026 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20031231 FILED AS OF DATE: 20040206 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: GILLILAND STANLEY E CENTRAL INDEX KEY: 0001185491 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-13368 FILM NUMBER: 04574709 BUSINESS ADDRESS: STREET 1: 1515 CHARLESTON AVE CITY: MATTOON STATE: IL ZIP: 61938 BUSINESS PHONE: 2172580484 MAIL ADDRESS: STREET 1: 27 S COUNTRY CLUB ROAD CITY: MATTOON STATE: IL ZIP: 61938 5 1 form5_gilliland-123103ex.xml X0201 5 2003-12-31 0 0 0 0000700565 FIRST MID ILLINOIS BANCSHARES INC FMBH.OB 0001185491 GILLILAND STANLEY E 27 S. COUNTRY CLUB ROAD MATTOON IL 61938 0 1 0 0 Vice President Common Stock 5055.678 D Common Stock 2003-08-22 5 P 0 22.783 42.20 A 7251.33 I By 401K Common Stock 2003-12-10 5 P 0 25.051 46.29 A 7276.384 I By 401K Common Stock 1448.031 I By Deferred Comp Common Stock 2227.562 I By IRA Stock Options 15.67 1998-10-21 2007-10-21 Common Stock 3000 3000 D Stock Options 22.49 1999-01-01 2008-01-12 Common Stock 1500 4500 D Stock Options 23.33 2000-01-01 2008-12-22 Common Stock 1500 6000 D Stock Options 23.00 2001-01-01 2009-12-13 Common Stock 1500 7500 D Stock Options 18.83 2002-01-01 2010-12-18 Common Stock 2250 9750 D Stock Options 24.00 2003-01-01 2011-12-18 Common Stock 2250 12000 D Stock Options 27.25 2004-01-01 2012-12-16 Common Stock 2250 14250 D Stock Options 46.50 2005-01-01 2013-12-16 Common Stock 2250 16500 D Options become exercisable in 4 equal annual installments beginning on 10/21/1998. Options become exercisable in 4 equal annual installments beginning on 01/01/1999. Options become exercisable in 4 equal annual installments beginning on 01/01/2000. Options become exercisable in 4 equal annual installments beginning on 01/01/2001. Options become exercisable in 4 equal annual installments beginning on 01/01/2002. Options become exercisable in 4 equal annual installments beginning on 01/01/2003. Options become exercisable in 4 equal annual installments beginning on 01/01/2004. Options become exercisable in 4 equal annual installments beginning on 01/01/2005. Michael L. Taylor, pursuant to a Power of Attorney filed on 12/19/2002. 2004-02-06 -----END PRIVACY-ENHANCED MESSAGE-----