0001127602-14-028701.txt : 20141001 0001127602-14-028701.hdr.sgml : 20141001 20141001153108 ACCESSION NUMBER: 0001127602-14-028701 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20140929 FILED AS OF DATE: 20141001 DATE AS OF CHANGE: 20141001 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: 0211 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: Lewis Amanda D CENTRAL INDEX KEY: 0001621192 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36434 FILM NUMBER: 141132853 MAIL ADDRESS: STREET 1: 300 W PLEASANT CITY: GREENUP STATE: IL ZIP: 62428 3 1 form3.xml PRIMARY DOCUMENT X0206 3 2014-09-29 0 0000700565 FIRST MID ILLINOIS BANCSHARES INC FMBH 0001621192 Lewis Amanda D 300 W PLEASANT GREENUP IL 62428 1 SVP Retail Banking Common Stock 1093.34 I By 401K plan /s/ Michael L. Taylor, attorney-in-fact for Ms. Lewis 2014-10-01