-----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, I21nXvNcdKuBOh67T7w8eIIx4oEIwAzCHrinCXqtOQ2/Yq3UvFXoPSWOiPtiO2oN oHAtld3A1S4HP1c/6lfysQ== 0001140361-09-028567.txt : 20091209 0001140361-09-028567.hdr.sgml : 20091209 20091209091853 ACCESSION NUMBER: 0001140361-09-028567 CONFORMED SUBMISSION TYPE: 4/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20091201 FILED AS OF DATE: 20091209 DATE AS OF CHANGE: 20091209 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: ADAMS CHARLES A /TX CENTRAL INDEX KEY: 0001185704 FILING VALUES: FORM TYPE: 4/A SEC ACT: 1934 Act SEC FILE NUMBER: 000-13368 FILM NUMBER: 091230055 MAIL ADDRESS: STREET 1: 21 ST. ANDREWS PLACE CITY: MATTOON STATE: IL ZIP: 61938 4/A 1 doc1.xml FORM 4/A X0303 4/A 2009-12-01 2009-12-03 0 0000700565 FIRST MID ILLINOIS BANCSHARES INC FMBH 0001185704 ADAMS CHARLES A /TX 1020 N 13TH STREET MATTOON IL 61938 1 0 0 0 Common Stock 69872.348 I By Spouse On December 3, 2009, the reporting person filed a Form 4 reporting a purchae of 5,000 shares of common stock that did not in fact occur. As of December 1, 2009, the spouse of the reporting person owned only 69,872.348 shares of common stock. Michael L. Taylor, pursuant to a power of attorney filed 11/01/02. 2009-12-08 -----END PRIVACY-ENHANCED MESSAGE-----