SEC Form 4
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*
HEDGES JOHN W

(Last) (First) (Middle)
4 PINEHURST DRIVE

(Street)
MATTOON IL 61938

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
FIRST MID ILLINOIS BANCSHARES INC [ FMBH.OB ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Pres First Mid-Illinois Bank
3. Date of Earliest Transaction (Month/Day/Year)
03/11/2005
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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 375 D
Common Stock 875.661 I By 401K
Common Stock 03/11/2005 P 79.29 A $41 2,281.758 I By Deferred Compensation Plan
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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
Stock Option $15.33 01/01/2001(1) 12/13/2009 Common Stock 4,500 4,500 D
Stock Option $12.56 01/01/2002(2) 12/18/2010 Common Stock 3,375 7,875 D
Stock Option $16 01/01/2003(3) 12/18/2011 Common Stock 3,375 11,250 D
Stock Option $18.17 01/01/2004(4) 12/16/2012 Common Stock 4,875 16,125 D
Stock Option $31 01/01/2005(5) 12/16/2013 Common Stock 4,875 21,000 D
Stock Option $41 01/01/2006(6) 12/14/2014 Common Stock 4,875 25,875 D
Explanation of Responses:
1. Options become exercisable in 4 equal annual installments beginning on 1/1/2001.
2. Options become exercisable in 4 equal annual installments beginning on 1/1/2002.
3. Options become exercisable in 4 equal annual installments beginning on 1/1/2003.
4. Options become exercisable in 4 equal annual installments beginning on 1/1/2004.
5. Options become exercisable in 4 equal annual installments beginning on 1/1/2005.
6. Options become exercisable in 4 equal annual installments beginning on 1/1/2006.
Michael L. Taylor, pursuant to a Power of Attorney filed on 11/01/2002. 03/14/2005
** 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.