FORM 4 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). |
1. Name and Address of Reporting Person*
(Street)
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2. Issuer Name and Ticker or Trading Symbol
FIRST MIDWEST BANCORP INC [ FMBI ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Date of Earliest Transaction
(Month/Day/Year) 02/24/2004 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed
(Month/Day/Year) |
6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | ||||||||||
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1. Title of Security (Instr. 3) | 2. Transaction Date (Month/Day/Year) | 2A. Deemed Execution Date, if any (Month/Day/Year) | 3. Transaction Code (Instr. 8) | 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) | 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) | 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 7. Nature of Indirect Beneficial Ownership (Instr. 4) | |||
Code | V | Amount | (A) or (D) | Price | ||||||
Common Stock | 1,172(1) | D | ||||||||
Common Stock | 3,921(2)(3) | I | By Profit Sharing Plan Trust |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
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1. Title of Derivative Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) | 6. Date Exercisable and Expiration Date (Month/Day/Year) | 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) | 8. Price of Derivative Security (Instr. 5) | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) | ||||
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Non-Qualified Stock Option (right to buy) | $32.715 | 02/24/2004 | A | 12,020 | (4) | 02/24/2014 | Common Stock | 12,020 | $0 | 12,020 | D | ||||
Non-Qualified Stock Option (right to buy) | $12.16 | (5) | 02/21/2006 | Common Stock | 3,719 | 3,719 | D | ||||||||
Non-Qualified Stock Option (right to buy) | $17.1 | (6) | 02/19/2007 | Common Stock | 2,763 | 2,763 | D | ||||||||
Non-Qualified Stock Option (right to buy) | $21.7 | (7) | 02/18/2008 | Common Stock | 2,444 | 2,444 | D | ||||||||
Non-Qualified Stock Option (right to buy) | $18.55 | (8) | 02/17/2009 | Common Stock | 2,973 | 2,973 | D | ||||||||
Non-Qualified Stock Option (right to buy) | $21.8334 | (9) | 08/18/2009 | Common Stock | 1,189 | 1,189 | D | ||||||||
Non-Qualified Stock Option (right to buy) | $18.4 | (10) | 02/16/2010 | Common Stock | 10,598 | 10,598 | D | ||||||||
Non-Qualified Stock Option (right to buy) | $22.5 | (11) | 02/21/2011 | Common Stock | 9,534 | 9,534 | D | ||||||||
Non-Qualified Stock Option (right to buy) | $28.695 | (12) | 02/20/2012 | Common Stock | 7,998 | 7,998 | D | ||||||||
Non-Qualified Stock Option (right to buy) | $29.25 | (13) | 08/21/2012 | Common Stock | 1,673 | 1,673 | D | ||||||||
Non-Qualified Stock Option (right to buy) | $26.255 | (14) | 02/19/2013 | Common Stock | 13,997 | 13,997 | D |
Explanation of Responses: |
1. Between February 20, 2003 and February 24, 2004 the reporting person acquired 31 shares of First Midwest common stock under the First Midwest Bancorp, Inc. Dividend Reinvestment Plan. The information in this report is based on a plan statement dated January 22, 2004. |
2. Between February 20, 2003 and February 24, 2004 the reporting person acquired 237 shares of First Midwest Bancorp, Inc. common stock under the First Midwest Bancorp, Inc. Savings and Profit Sharing Plan. The information in this report is based on a plan statement dated February 10, 2004. |
3. Between February 20, 2003 and February 24, 2004 the reporting person acquired 92 shares of First Midwest common stock pursuant to the dividend reinvestment feature under the First Midwest Bancorp, Inc. Savings and Profit Sharing Plan. The information in this report is based on a plan statement dated January 28, 2004. |
4. The stock option vests in two equal annual installments beginning on February 24, 2006. |
5. The stock option vests in two equal annual installments beginning on February 21, 1998. |
6. The stock option vests in two equal annual installments beginning on February 19, 1999. |
7. The stock option vests in two equal annual installments beginning on February 18, 2000. |
8. The stock option vests in two equal annual installments beginning on February 17, 2001. |
9. The stock option vests in two equal annual installments beginning on August 18, 2001. |
10. The stock option vests in two equal annual installments beginning on February 16, 2002. |
11. The stock option vests in two equal annual installments beginning on February 21, 2003. |
12. The stock option vests in two equal annual installments beginning on February 20, 2004. |
13. The stock option vests in two equal annual installments beginning on August 21, 2004. |
14. The stock option vests in two equal annual installments beginning on February 19, 2005. |
Remarks: |
By: Andrea L. Stangl, Attorney-in-fact for | 02/26/2004 | |
** Signature of Reporting Person | Date | |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v). | ||
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). | ||
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |