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