-----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, JB5XyZXWBgsN0z2JwRemfl3fmXbp+LBhq37NbFB7pHKnPHnro7OYXZ7CSFchwI+H WTqYu6fy8cfFz2XAMOScCQ== 0000700565-04-000099.txt : 20040614 0000700565-04-000099.hdr.sgml : 20040611 20040614095216 ACCESSION NUMBER: 0000700565-04-000099 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040610 FILED AS OF DATE: 20040614 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 FORMER COMPANY: FORMER CONFORMED NAME: FIRST-MID ILLINOIS BANCSHARES INC DATE OF NAME CHANGE: 19920703 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: 04859891 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-061104ex.xml X0202 4 2004-06-10 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 2004-01-09 5 J 0 32.371 46.50 A 3795.489 I By Wife Common Stock 2004-06-10 4 G 0 225 48.50 D 3570.489 I By Wife Common Stock 2004-06-10 4 G 0 225 48.50 A 3795.489 I By Wife Common Stock 2004-01-09 5 J 0 325.838 46.50 A 38204.499 I By Sparks Investment Group Common Stock 2004-01-09 5 J 0 612.179 46.50 A 71777.991 D Common Stock 2004-06-10 4 G 0 1400 48.50 D 70377.991 D Common Stock 2004-06-10 4 G 0 225 48.50 D 70152.991 D Common Stock 2004-06-10 4 G 0 225 48.50 D 69927.991 D Common Stock 2004-01-09 5 J 0 60.086 46.50 A 7217.234 I By Deferred Comp Common Stock 2004-06-10 4 G 0 225 48.50 A 225 I By Child Common Stock 2004-06-10 4 G 0 225 48.50 A 450 I By Child Common Stock 2004-06-10 4 G 0 1400 48.50 A 1400 I By The Sparks Foundation Stock Option 46.50 2003-12-16 2013-12-16 Common Stock 1500 1500 D Shares purchased through the company's dividend reinvestment plan with dividends paid on shares of common stock held. On June 10, 2004, Debra Sparks gifted 225 shares of common stock to her daughter Melinda. On June 10, 2004, Ray A. Sparks gifted 225 shares of common stock to his wife Debra. On June 10, 2004, Ray A. Sparks gifted 1,400 shares of common stock to The Sparks Foundation. On June 10, 2004, Ray A. Sparks gifted 225 shares of common stock to his daughter Melinda. Michael L. Taylor, pursuant to a power of attorney filed 09/06/2002 2004-06-14 -----END PRIVACY-ENHANCED MESSAGE-----