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