-----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, Tc2EBCj9PxMQG9ELGm4WFq9rzmILG1zHTletgF2A3ykXwY0Kpud+zjy3jgFb5/os 7I92fTuWWno+CC5ytURlyA== 0000700565-04-000034.txt : 20040206 0000700565-04-000034.hdr.sgml : 20040206 20040206164016 ACCESSION NUMBER: 0000700565-04-000034 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: ALLENBAUGH LAUREL G CENTRAL INDEX KEY: 0001185501 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-13368 FILM NUMBER: 04574804 BUSINESS ADDRESS: STREET 1: 1515 CHARLESTON AVE CITY: MATTOON STATE: IL ZIP: 61938 BUSINESS PHONE: 2172580610 MAIL ADDRESS: STREET 1: 3015 WESTERN AVE CITY: MATTOON STATE: IL ZIP: 61938 5 1 form5_allenbaugh-123103ex.xml X0201 5 2003-12-31 0 0 0 0000700565 FIRST MID ILLINOIS BANCSHARES INC FMBH.OB 0001185501 ALLENBAUGH LAUREL G 3015 WESTERN AVE MATTOON IL 61938 0 1 0 0 Vice President Common Stock 2003-08-22 5 P 0 10.669 42.55 A 519.23 I By 401K Common Stock 2003-12-10 5 P 0 10.808 46.28 A 530.035 I By 401K Stock Option 18.83 2002-01-01 2010-12-18 Common Stock 1500 1500 D Stock Option 24.00 2003-01-01 2011-12-18 Common Stock 1500 3000 D Stock Option 27.25 2004-01-01 2012-12-16 Common Stock 1500 4500 D Stock Option 46.50 2005-01-01 2013-12-16 Common Stock 1500 6000 D 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. Laurel G. Allenbaugh 2004-02-06 -----END PRIVACY-ENHANCED MESSAGE-----