0001140361-12-016962.txt : 20120321 0001140361-12-016962.hdr.sgml : 20120321 20120321170350 ACCESSION NUMBER: 0001140361-12-016962 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20120320 FILED AS OF DATE: 20120321 DATE AS OF CHANGE: 20120321 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: GRISSOM STEVEN L CENTRAL INDEX KEY: 0001073304 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-13368 FILM NUMBER: 12706501 MAIL ADDRESS: STREET 1: CONSOLIDATED COMMUNICATIONS INC STREET 2: 121 S 17TH ST CITY: MATTOON STATE: IL ZIP: 61938 4 1 doc1.xml FORM 4 X0304 4 2012-03-20 0 0000700565 FIRST MID ILLINOIS BANCSHARES INC FMBH 0001073304 GRISSOM STEVEN L C/O SKL INVESTMENT GROUP 121 S. 17TH STREET MATTOON IL 61938 1 0 0 0 Common Stock 2012-03-20 4 J 0 6122 0 A 198096 I By Trust FBO Benjamin I. Lumpkin Common Stock 2012-03-20 4 J 0 6122.00 0 A 198096 I By Trust FBO Elizabeth L. Celio Common Stock 2012-03-20 4 J 0 300.00 0 A 300.00 I By 1978 Trust FBO Mary Lee Sparks Common Stock 43142.50 D Common Stock 2298.412 I By Deferred Comp Plan Shares acquired through a distribution of common stock held by SKL Investment Group, LLC. Shares acquired by Mr. Grissom as co-trustee of the trust. Mr. Grissom disclaims beneficial ownership of these shares. Shares include 48.937 shares acquired through the Company's dividend reinvestment plan with dividends being paid on shares of common stock held. Michael L. Taylor, pursuant to a power of attorney filed 12/19/02. 2012-03-21