0001181431-15-008530.txt : 20150622 0001181431-15-008530.hdr.sgml : 20150622 20150622172123 ACCESSION NUMBER: 0001181431-15-008530 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20150619 FILED AS OF DATE: 20150622 DATE AS OF CHANGE: 20150622 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: 1231 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: Cook Robert S CENTRAL INDEX KEY: 0001615123 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36434 FILM NUMBER: 15945465 MAIL ADDRESS: STREET 1: 631 S BODIN ST CITY: HINSDALE STATE: IL ZIP: 60521 4 1 rrd425886.xml X0306 4 2015-06-19 0 0000700565 FIRST MID ILLINOIS BANCSHARES INC FMBH 0001615123 Cook Robert S 631 S BODIN ST HINSDALE IL 60521 1 0 0 0 Common Stock 2015-06-19 4 A 0 7143 21.00 A 14122 D /s/ Michael L. Taylor, attorney-in-fact for Mr. Cook 2015-06-22