0001140361-12-047692.txt : 20121116 0001140361-12-047692.hdr.sgml : 20121116 20121116152610 ACCESSION NUMBER: 0001140361-12-047692 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20121115 FILED AS OF DATE: 20121116 DATE AS OF CHANGE: 20121116 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 SEC ACT: 1934 Act SEC FILE NUMBER: 000-13368 FILM NUMBER: 121211521 MAIL ADDRESS: STREET 1: 21 ST. ANDREWS PLACE CITY: MATTOON STATE: IL ZIP: 61938 4 1 doc1.xml FORM 4 X0306 4 2012-11-15 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 2012-11-15 4 P 0 382.016 24.50 A 58960.959 I By Deferred Compensation Plan Common Stock 78707.159 I By Spouse Common Stock 134113.776 D Common Stock 276146.351 I By Howell Paving Inc. Includes 980.392 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 11/01/2002 2012-11-16