0001140361-12-025081.txt : 20120514 0001140361-12-025081.hdr.sgml : 20120514 20120514180959 ACCESSION NUMBER: 0001140361-12-025081 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20120511 FILED AS OF DATE: 20120514 DATE AS OF CHANGE: 20120514 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: 000-13368 FILM NUMBER: 12840205 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: 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 X0305 4 2012-05-11 0 0000700565 FIRST MID ILLINOIS BANCSHARES INC FMBH 0001301318 Dively Joseph R 13179 E. COUNTY ROAD 720N CHARLESTON IL 61920 1 1 0 0 President-FMIB&T Common Stock 2012-05-11 4 P 0 316.815 22.50 A 8527.175 I By Deferred Compensation Plan Common Stock 6740.958 D Includes 565.217 shares acquired through the Company's dividend reinvestment plan with dividends being paid on shares of preferred stock held. Michael L. Taylor, pursuant to a power of attorney filed 08/25/04. 2012-05-14