0001127602-17-027072.txt : 20170906
0001127602-17-027072.hdr.sgml : 20170906
20170906172136
ACCESSION NUMBER: 0001127602-17-027072
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20170905
FILED AS OF DATE: 20170906
DATE AS OF CHANGE: 20170906
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Dively Joseph R
CENTRAL INDEX KEY: 0001301318
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36434
FILM NUMBER: 171072144
MAIL ADDRESS:
STREET 1: 13179 E. COUNTY ROAD 720N
CITY: CHARLESTON
STATE: IL
ZIP: 61920
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
4
1
form4.xml
PRIMARY DOCUMENT
X0306
4
2017-09-05
0000700565
FIRST MID ILLINOIS BANCSHARES INC
FMBH
0001301318
Dively Joseph R
1421 CHARLESTON AVE
MATTOON
IL
61938
1
1
CEO
Common Stock
2017-09-05
4
A
0
498.313
35.08
A
33433.966
I
By Deferred Compensation Plan
Common Stock
39857.7679
D
/s/ Michael L. Taylor, attorney-in-fact for Mr. Dively
2017-09-06