-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, Jh5T5o2Y7QJhY4ipLaby5d0/MXTCbEAyre5WpvWkA4l5FmSVTuHDoIfcLzxaWGyG WS6lEt/PjiwEOfAlgZ6tDw== 0001140361-10-046204.txt : 20101117 0001140361-10-046204.hdr.sgml : 20101117 20101117135940 ACCESSION NUMBER: 0001140361-10-046204 CONFORMED SUBMISSION TYPE: SC 13D/A PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20101117 DATE AS OF CHANGE: 20101117 SUBJECT COMPANY: 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 FILING VALUES: FORM TYPE: SC 13D/A SEC ACT: 1934 Act SEC FILE NUMBER: 005-36284 FILM NUMBER: 101199312 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 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: ADAMS CHARLES A /TX CENTRAL INDEX KEY: 0001185704 FILING VALUES: FORM TYPE: SC 13D/A MAIL ADDRESS: STREET 1: 21 ST. ANDREWS PLACE CITY: MATTOON STATE: IL ZIP: 61938 SC 13D/A 1 doc1.htm Schedule 13D
UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549



SCHEDULE 13D
Under the Securities Exchange Act of 1934
(Amendment No. 04 )*

First Mid-Illinois Bancshares, Inc.
(Name of Issuer)


Common Stock, par value $4.00 per share
(Title of Class of Securities)


320866106
(CUSIP Number)


Charles Albert Adams,  21 St. Andrews Place  Mattoon,  Illinois  61938  Phone : 217-234-8877
(Name, Address and Telephone Number of Person Authorized to Receive Notices and Communications)


November 09, 2010
(Date of Event which Requires Filing of this Statement)



If the filing person has previously filed a statement on Schedule 13G to report the acquisition that is the subject of this Schedule 13D, and is filing this schedule because of §§240.13d-1(e), 240.13d-1(f) or 240.13d-1(g), check the following box.    o

Note: Schedules filed in paper format shall include a signed original and five copies of the schedule, including all exhibits. See §240.13d-7 for other parties to whom copies are to be sent.

* The remainder of this cover page shall be filled out for a reporting person’s initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter disclosures provided in a prior cover page.

The information required on the remainder of this cover page shall not be deemed to be “filed” for the purpose of Section 18 of the Securities Exchange Act of 1934 (“Act”) or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes).
 

1
NAMES OF REPORTING PERSONS
   
I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY)
   
Charles Albert Adams
    
   
2
CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP
(a)
o
 
(b)
x
   
3
SEC USE ONLY
   
     
   
4
SOURCE OF FUNDS
   
PF
    
   
5
CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT TO ITEM 2(e) or 2(f)
 
o
 
   
   
6
CITIZENSHIP OR PLACE OF ORGANIZATION
   
United States of America
    
   
NUMBER OF SHARES BENEFICIALLY OWNED BY EACH REPORTING PERSON WITH
7
SOLE VOTING POWER
   
517,917
    
   
8
SHARED VOTING POWER
   
19,000
    
   
9
SOLE DISPOSITIVE POWER
   
517,917
    
   
10
SHARED DISPOSITIVE POWER
   
19,000
    
   
11
AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
   
536,917
    
   
12
CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES
 
o
 
   
   
13
PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11)
   
8.8%
   
   
14
TYPE OF REPORTING PERSON
   
IN
    
   
 
 
 
 
Item 1.
Security and Issuer
  
 
 
This statement relates to the common stock, par value $4.00 per share (the "Common Stock"), of First Mid-Illinois Bancshares, Inc., a Delaware corporation (the "Company"), whose principal executive offices are located at 1515 Charleston Avenue, Mattoon, Illinois 61938.
 
Item 2.
Identity and Background
  
 
 
(a)
This statement is being filed by Charles Albert Adams individiually.

 
(b)
Mr. Adams residence address is 21 St. Andrews Place, Mattoon, Illinois 61938.

 
(c)
Mr. Adams principal occupation is President of Howell Paving, Inc. His business address is 1020 N. 13th Street, Mattoon, Illinois 61938.

 
(d)
During the last five years, Mr. Adams has not been convicted in a criminal proceeding (excluding traffic violations or similar misdemeanors).

 
(e)
During the last five years, Mr. Adams has not been a party to a civil proceeding of a judicial or administrative body of c ompetent jurisdiction resulting in a judgment, decree or final order finding any violation with respect to federal or state securities laws or enjoining future violations of, or prohibiting or mandating activities subject to, such laws.

 
(f)
Mr. Adams is a citizen of the United States of America.
 
Item 3.
Source and Amount of Funds or Other Consideration
  
 
 
Since Mr. Adams most recently filed amendment to this statement on Schedule 13D on June 29, 2005, shares of Common Stock for which Mr. Adams is reporting beneficial ownership herein have been acquired in the following manner: (i) 5,654 shares acquired pursuant to the deferral of director fees under the Company's Deferred Compensation Plan; (ii) 32,894 shares have been acquired pursuant to dividend reinvestment under the Company's Dividend Reinvestment Plan; (iii) 192,036 shares have been acquired pursuant to the three-for-two stock split effected by the Company on June 29, 2007; and (iv) 45,400 shares are obtainable through the conversion of 200 shares of Series B 9% Non-Cumulative Perpetual Convertible Preferred Stock of the Company (the "Series B Preferred Stock") that have been acquired by Mr. Adams individually through a private placement offering by the Company of the Series B Preferred Stock on November 16, 2009. No borrowed funds were used for any of the above listed acquisitions. Additionally, Mr. Adams' percentage of beneficial ownership of shares of Common Stock has increased as a result of Common Stock repurchases under the Company's share buy-back program.
 
Item 4.
Purpose of Transaction
  
 
Purchases of shares of Common Stock by Mr. Adams have been for investment purposes. Mr. Adams may purchase additional shares from time to time depending upon price, market conditions, availability of funds, evaluation of other investment opportunities, and other factors. Mr. Adams has no present intention to sell any shares, although he could determine from time to time, based upon the same factors listed above for purchases, to sell some or all of the shares held by him. Except as set forth above, Mr. Adams does not have any plans or proposal which relates to or would result in any of the following matters:

 
(a)

 
(b)

 
(c)

 
(d)

 60;
(e)

 
(f)

 
(g)

 
(h)

 
(i)

 
(j)
 
Item 5.
Interest in Securities of the Issuer
  
 
(a)
Mr. Adams' total beneficial ownership amounts to 536,917 shares of Common Stock, or 8.8% of the outstanding shares of Common Stock of the Company.

 
(b)
Mr. Adams holds sole voting and investment power over the following shares of Common Stock: (i) 134,114 held by Mr. Adams individually; (ii) 53,882 shares held for the account of Mr. Adams under the Company's Deferred Compensation Plan; (iii) options to purchase 3,375 shares of Common Stock; (iv) 281,146 shares held by Howell Paving, Inc., which is a Corporation controlled by Mr. Adams; and (v) 200 shares of Series B Preferred Stock of the Company, which are convertible into 45,400 shares of Common Stock of the Company. Mr. Adams is also reporting shared voting and investment power over 19,000 shares held by the Howell-Adams Family Foundation.

 
(c)
During the past 60 days, Mr. Adams has effected no transactions in the Common Stock other than the following: (i) On November 9, 2010, Mr. Adams acquired 356 shares of Common Stock through the Company's Deferred Compensation Plan. The price per share was $18.25.

 
 
Transact ion Date Shares or Unites Purchased (Sold) Price Per Share or Unit 
 
 

 
 
 

 
 

 
(d)
Other than the persons described in sub-items (a) & (b) above, to the knowledge of Mr. Adams, no other person has the right to recei ve or the power to direct the receipt of dividends from, or proceeds from the sale of , the shares of Common Stock beneficially owned by Mr. Adams.

 
(e)
Not Applicable.
 
Item 6.
Contracts, Arrangements, Understandings or Relationships with Respect to Securities of the Issuer
  
 
< font style="DISPLAY: inline; FONT-FAMILY: times new roman; FONT-SIZE: 10pt"> 
There are no contracts, arrangements, understandings or relationships (legal or otherwise) between Mr. Adams and any person with respect to any securities of the issuer.
 
Item 7.
Material to Be Filed as Exhibits
  
 
 
None.
 
Signature
 
After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct.

 
 
       
November 17, 2010
By:
/s/ Charles Albert Adams
  
   
 
       
 
The original statement shall be signed by each person on whose behalf the statement is filed or his authorized representative. If the statement is signed on behalf of a person by his authorized representative (other than an executive officer or general partner of the filing person), evidence of the representative’s authority to sign on behalf of such person shall be filed with the statement: provided, however, that a power of attorney for this purpose which is already on file with the Commission may be incorporated by reference. The name and any title of each person who signs the statement shall be typed or printed beneath his signature.

Footnotes: 
 
Attention: Intentional misstatements or omissions of fact constitute Federal criminal violations (See 18 U.S.C. 1001)
 
 
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