-----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, TPNS749W1Hbm2fx/HcRdplPBPfxt0H2CKc4/i+KSTMq7kdJutHC0cbgK7JSq4qH6 HRmbEXYEj0NLmfadcqaFWA== 0000700565-05-000220.txt : 20051123 0000700565-05-000220.hdr.sgml : 20051123 20051123145340 ACCESSION NUMBER: 0000700565-05-000220 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20051122 FILED AS OF DATE: 20051123 DATE AS OF CHANGE: 20051123 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: 051224565 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-112205ex.xml RAY A. SPARKS X0202 4 2005-11-22 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 103308 D Common Stock 2005-11-22 4 P 0 155.733 40.25 A 12157.767 I By Deferred Comp Common Stock 1215 I By Child Common Stock 6100 I By The Sparks Foundation Stock Option 41.00 2004-12-14 2014-12-14 Common Stock 2250 2250 D Michael L. Taylor, pursuant to a power of attorney filed 09/06/2002 2005-11-23 -----END PRIVACY-ENHANCED MESSAGE-----