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