-----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, GOIy74+jVQToxfWhMIzKI1spge0i3nEknxdySlhaIPJnBgQvUJ6Ubo3nQccogUQi ybJgJWNq2HSLDZeHsrXsEg== 0000700565-05-000103.txt : 20050316 0000700565-05-000103.hdr.sgml : 20050316 20050316150918 ACCESSION NUMBER: 0000700565-05-000103 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20050315 FILED AS OF DATE: 20050316 DATE AS OF CHANGE: 20050316 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: LUMPKIN RICHARD ANTHONY CENTRAL INDEX KEY: 0000925184 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-13368 FILM NUMBER: 05685071 MAIL ADDRESS: STREET 1: 121 SOUTH 17TH STREET CITY: MATTOON STATE: IL ZIP: 61938 4 1 form4_lumpkin-031505ex.xml RICHARD A. LUMPKIN X0202 4 2005-03-15 0 0000700565 FIRST MID ILLINOIS BANCSHARES INC FMBH.OB 0000925184 LUMPKIN RICHARD ANTHONY 121 SOUTH 17TH STREET MATTOON IL 61938 1 0 0 0 Common Stock 180566.000 D Common Stock 66989.000 I By SKL Investment Group, R.A. Lumpkin voting member Common Stock 37746.000 I By Trust Common Stock 2005-03-15 4 P 0 7.976 41.00 A 32109.413 I By Deferred Comp Stock Option 10.45 1997-10-21 2007-10-21 Common Stock 1125 1125 D Stock Option 14.99 1997-12-15 2008-01-12 Common Stock 1125 2250 D Stock Option 15.55 1998-12-15 2008-12-22 Common Stock 1125 3375 D Stock Option 15.33 1999-12-13 2009-12-13 Common Stock 1125 4500 D Stock Option 12.55 2000-12-18 2010-12-18 Common Stock 1125 5625 D Stock Option 16.00 2001-12-18 2011-12-18 Common Stock 1500 7125 D Stock Option 18.17 2002-12-16 2012-12-16 Common Stock 1500 8625 D Stock Option 31.00 2003-12-16 2013-12-16 Common Stock 2250 10875 D Stock Option 41.00 2004-12-14 2014-12-14 Common Stock 2250 13125 D Michael L. Taylor, pursuant to a power of attorney filed 12/19/2002 2005-03-16 -----END PRIVACY-ENHANCED MESSAGE-----