-----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, TtY3HuRA5n+QGVvQZK4P+aDyrH1sUbL0Qzo/xcp6DSYHc7T5MeTBqOWOv4Hp//r8 kiyWDRpMIhfDpYPqHsKeJw== 0000700565-05-000065.txt : 20050301 0000700565-05-000065.hdr.sgml : 20050301 20050301121759 ACCESSION NUMBER: 0000700565-05-000065 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20050228 FILED AS OF DATE: 20050301 DATE AS OF CHANGE: 20050301 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: 05648859 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-022805ex.xml RAY A. SPARKS X0202 4 2005-02-28 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 5730 I By Wife Common Stock 57682.000 I By Sparks Investment Group Common Stock 107348.000 D Common Stock 2005-01-07 5 J 0 66.555 41.00 A 11436.302 I By Deferred Comp Common Stock 2005-02-28 4 P 0 136.905 40.55 A 11573.207 I By Deferred Comp Common Stock 675 I By Child Common Stock 2600 I By The Sparks Foundation Stock Option 41.00 2004-12-14 2014-12-14 Common Stock 2250 2250 D Shares acquired through the Company's Dividend Reinvestment Plan with dividends paid on shares of common stock held. Michael L. Taylor, pursuant to a power of attorney filed 09/06/2002 2005-03-01 -----END PRIVACY-ENHANCED MESSAGE-----