-----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, BSVqCow9CjGlJGvoNXkF1QZN+WMMS4Av6CK3q03XTB2d00v7/koyvvmV1Mv7/W8z nqnkgxxcfv/HZNHgzkdRDA== 0000700565-05-000004.txt : 20050103 0000700565-05-000004.hdr.sgml : 20041231 20050103141150 ACCESSION NUMBER: 0000700565-05-000004 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20041231 FILED AS OF DATE: 20050103 DATE AS OF CHANGE: 20050103 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: SWIFT ROBERT J CENTRAL INDEX KEY: 0001185504 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-13368 FILM NUMBER: 05501792 BUSINESS ADDRESS: STREET 1: 1515 CHARLESTON AVE CITY: MATTOON STATE: IL ZIP: 61938 BUSINESS PHONE: 2172580652 MAIL ADDRESS: STREET 1: 6807 N COUNTRY CLUB ROAD CITY: MATTOON STATE: IL ZIP: 61938 4 1 form4_swift-123104ex.xml ROBERT SWIFT FORM 4 2/13/04 X0202 4 2004-12-31 0 0000700565 FIRST MID ILLINOIS BANCSHARES INC FMBH.OB 0001185504 SWIFT ROBERT J 6807 N COUNTRY CLUB RD MATTOON IL 61938 0 1 0 0 EVP for Trust Common Stock 599.255 I By 401K Common Stock 2004-12-31 4 P 0 40.963 37.00 A 1284.023 I By Deferred Comp Stock Option 12.56 2004-01-01 2010-12-18 Common Stock 843.75 843.75 D Stock Option 16.00 2004-01-01 2011-12-18 Common Stock 1687.50 2531.25 D Stock Option 18.17 2004-01-01 2012-12-16 Common Stock 2531.25 5062.50 D Stock Option 31.00 2005-01-01 2013-12-16 Common Stock 3375 8437.50 D Stock Option 41.00 2006-01-01 2014-12-14 Common Stock 3375 11812.5 D Options become exercisable on 1/1/2005. Options become exercisable in 2 equal annual installments beginning on 1/1/2005. Options become exercisable in 3 equal annual installments beginning on 1/1/2005. Options become exercisable in 4 equal annual installments beginning on 1/1/2005. Options become exercisable in 4 equal annual installments beginning on 1/1/2006. Michael L. Taylor, pursuant to a power of attorney filed 11/01/2002 2005-01-03 -----END PRIVACY-ENHANCED MESSAGE-----