0001140361-12-016958.txt : 20120321 0001140361-12-016958.hdr.sgml : 20120321 20120321170231 ACCESSION NUMBER: 0001140361-12-016958 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20120320 FILED AS OF DATE: 20120321 DATE AS OF CHANGE: 20120321 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Lumpkin Benjamin I. CENTRAL INDEX KEY: 0001454931 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-13368 FILM NUMBER: 12706486 MAIL ADDRESS: STREET 1: 340 E. RANDOLPH STREET UNIT 5403 CITY: CHICAGO STATE: IL ZIP: 60601 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 4 1 doc1.xml FORM 4 X0304 4 2012-03-20 0 0000700565 FIRST MID ILLINOIS BANCSHARES INC FMBH 0001454931 Lumpkin Benjamin I. 340 E. RANDOLPH ST, UNIT 5403 CHICAGO IL 60601 1 0 0 0 Common Stock 2012-03-20 4 J 0 4004.00 0 A 285416 D Shares acquired through a distribution of common stock held by SKL Investment Group, LLC. Michael L. Taylor, pursuant to a power of attorney filed 01/29/09. 2012-03-21