-----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, AyeKKgPFC41hMfTDfi3CcStYqtvJlsamH5AyXc1ah0Wdq65koDvNqHWQndAaiRGr Ad/5Y4bmWBbAGfAskw9qJg== 0000700565-04-000152.txt : 20041001 0000700565-04-000152.hdr.sgml : 20041001 20041001083544 ACCESSION NUMBER: 0000700565-04-000152 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040930 FILED AS OF DATE: 20041001 DATE AS OF CHANGE: 20041001 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: ROWLAND WILLIAM S CENTRAL INDEX KEY: 0001185508 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-13368 FILM NUMBER: 041056580 BUSINESS ADDRESS: STREET 1: 1515 CHARLESTON AVE CITY: MATTOON STATE: IL ZIP: 61938 BUSINESS PHONE: 2172580415 MAIL ADDRESS: STREET 1: #1 PRAIRIE SUN LANE CITY: MATTOON STATE: IL ZIP: 61938 4 1 form4_rowland-093004ex.xml X0202 4 2004-09-30 0 0000700565 FIRST MID ILLINOIS BANCSHARES INC FMBH.OB 0001185508 ROWLAND WILLIAM S # 1 PRAIRIE SUN LANE MATTOON IL 61938 0 1 0 0 Pres & Chief Executive Officer Common Stock 3564.694 I By 401K Common Stock 2004-06-18 5 J 0 23.971 48.75 A 16426.185 I By IRA Common Stock 2004-06-18 5 J 0 2.745 48.75 A 631.484 D Common Stock 2004-06-18 5 J 0 17.093 48.75 A 2621.042 I By Deferred Comp Common Stock 2004-09-30 4 P 0 1.458 32.50 A 3933.021 I By Deferred Comp Stock Option 10.45 1998-10-21 2007-10-21 Common Stock 9000 9000 D Stock Option 14.99 1999-10-01 2008-01-12 Common Stock 4500 13500 D Stock Option 15.56 2000-01-01 2008-12-22 Common Stock 4500 18000 D Stock Option 15.33 2001-01-01 2009-12-13 Common Stock 12375 30375 D Stock Option 12.56 2002-01-01 2010-12-18 Common Stock 5625 36000 D Stock Option 16.00 2003-01-01 2011-12-18 Common Stock 13500 49500 D Stock Option 18.17 2004-01-01 2012-12-16 Common Stock 12000 61500 D Stock Option 31.00 2005-01-01 2013-12-16 Common Stock 12000 73500 D Options become exerciseable in 4 equal annual installments beginning on 10/21/1998. Options become exerciseable in 4 equal annual installments beginning on 01/01/1999. Options become exerciseable in 4 equal annual installments beginning on 01/01/2000. Options become exerciseable in 4 equal annual installments beginning on 01/01/2001. Options become exerciseable in 4 equal annual installments beginning on 01/01/2002. Options become exerciseable in 4 equal annual installments beginning on 01/01/2003. Options become exerciseable in 4 equal annual installments beginning on 01/01/2004. Options become exerciseable in 4 equal annual installments beginning on 01/01/2005. Shares purchased through the company's dividend reinvestment plan with dividends paid on shares of common stock held. Share balance has been adjusted to reflect a 3 for 2 stock split that occurred on July 16, 2004. William S. Rowland 2004-10-01 -----END PRIVACY-ENHANCED MESSAGE-----