-----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, WwKe4jrKdl87lDA2wVfZECMYCQwVL4fW0k1c5a89xiI8XeiE+58cKEFp8fZGlZEE VA7UER0WdlJFsmSQuNHGGw== 0000700565-04-000047.txt : 20040210 0000700565-04-000047.hdr.sgml : 20040210 20040210133034 ACCESSION NUMBER: 0000700565-04-000047 CONFORMED SUBMISSION TYPE: SC 13D PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20040210 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: KEON MARGARET LUMPKIN CENTRAL INDEX KEY: 0000924869 FILING VALUES: FORM TYPE: SC 13D BUSINESS ADDRESS: STREET 1: 16 MILLER AVE STREET 2: STE 203 CITY: MILL VALLEY STATE: CA ZIP: 94941 BUSINESS PHONE: 4153815366 MAIL ADDRESS: STREET 1: 121 SOUTH 17TH STREET CITY: MATTOON STATE: IL ZIP: 61938 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: 1231 FILING VALUES: FORM TYPE: SC 13D SEC ACT: 1934 Act SEC FILE NUMBER: 005-36284 FILM NUMBER: 04581012 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 SC 13D 1 mkeon13d020904.txt MARGARET KEON 02092004 SECURITIES AND EXCHANGE COMMISSION WASHINGTON, DC 20549 ---------------- SCHEDULE 13D (Rule 13d-101) INFORMATION TO BE INCLUDED IN STATEMENTS FILED PURSUANT TO RULE 13d-1(a) AND AMENDMENTS THERETO FILED PURSUANT TO RULE 13d-2(a) (Amendment No. 3)(1) First Mid-Illinois Bancshares, Inc. - -------------------------------------------------------------------------------- (Name of Issuer) Common Stock, par value $4.00 per share - -------------------------------------------------------------------------------- (Title of Class of Securities) 320866106 - -------------------------------------------------------------------------------- (CUSIP Number) Margaret Lumpkin Keon c/o Keon Enterprises 16 Miller Avenue, Suite 203 Mill Valley, California 94941 (415)381-5366 - -------------------------------------------------------------------------------- (Name, Address and Telephone Number of Person Authorized to Receive Notices and Communications) February 9, 2004 - -------------------------------------------------------------------------------- (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 Rule 13d-1(e), 13d-1(f) or 13d-1(g), check the following box [_]. Note: Schedules filed in paper format shall include a signed original and five copies of the schedule, including all exhibits. See Rule 13d-7 for other parties to whom copies are to be sent. (Continued on following pages) (Page 1 of 5 Pages) - ---------- (1) 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 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). CUSIP No.320866106 13D Page 2 of 5 Pages ________________________________________________________________________________ 1 NAME OF REPORTING PERSONS I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY) Margaret Lumpkin Keon ________________________________________________________________________________ 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a) [_] (b) [X] ________________________________________________________________________________ 3 SEC USE ONLY ________________________________________________________________________________ 4 SOURCE OF FUNDS* PF ________________________________________________________________________________ 5 CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT TO ITEMS 2(d) OR 2(e) [_] ________________________________________________________________________________ 6 CITIZENSHIP OR PLACE OF ORGANIZATION United States of America ________________________________________________________________________________ 7 SOLE VOTING POWER NUMBER OF 92,854 SHARES _________________________________________________________________ 8 SHARED VOTING POWER BENEFICIALLY 44,368 OWNED BY _________________________________________________________________ EACH 9 SOLE DISPOSITIVE POWER REPORTING 92,854 PERSON _________________________________________________________________ 10 SHARED DISPOSITIVE POWER WITH 44,368 ________________________________________________________________________________ 11 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 137,222 ________________________________________________________________________________ 12 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES* [_] ________________________________________________________________________________ 13 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11) 4.6% ________________________________________________________________________________ 14 TYPE OF REPORTING PERSON* IN ________________________________________________________________________________ *SEE INSTRUCTIONS BEFORE FILLING OUT! CUSIP No. 320866106 13D Page 3 of 5 Pages ________________________________________________________________________________ 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. This statement is being filed by Margaret Lumpkin Keon, individually and as trustee of the trusts described in Item 5 below. Ms. Keon is a citizen of the United States of America. Her principal occupation is managing her investments. Her business address is as follows: Keon Enterprises, 16 Miller Avenue, Suite 203, Mill Valley, California 94941. During the last five years, Ms. Keon (i) has not been convicted in a criminal proceeding (excluding traffic violations or similar misdemeanors) and (ii) has not been a party to a civil proceeding of a judicial or administrative body of competent jurisdiction 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. ________________________________________________________________________________ Item 3. Source and Amount of Funds or Other Consideration. Since Ms. Keon's most recently filed amendment to this statement on November 1, 2002, 1,854 shares of Common Stock for which Ms. Keon is reporting beneficial ownership herein have been acquired pursuant to dividend reinvestment under the Company's Dividend Reinvestment Plan. No borrowed funds were used for the above listed acquisition. In addition to this acquisition, Ms. Keon has disposed of shares since her most recently filed amendment to this statement on Schedule 13D, which shares are no longer reported herein, as described in Item 5 below. ________________________________________________________________________________ Item 4. Purpose of Transaction. Purchases of shares of Common Stock by Ms. Keon have been for investment purposes. Ms. Keon may purchase additional shares from time to time depending upon price, market conditions, availability of funds, evaluation of other investment opportunities, and other factors. Other than as described in Item 5 below, Ms. Keon has no present intention to sell any shares, although she 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 her. Except as set forth above, Ms. Keon does not have any plan or proposal which relates to or would result in any of the following matters: (a) The acquisition by any person of additional securities of the issuer, or the disposition of securities of the issuer; (b) An extraordinary corporate transaction, such as a merger, reorganization or liquidation, involving the issuer or any of its subsidiaries; (c) A sale or transfer of a material amount of assets of the issuer or of any of its subsidiaries; (d) Any change in the present board of directors or management of the issuer, including any plans or proposals to change the number or term of directors or to fill any existing vacancies on the board; (e) Any material change in the present capitalization or dividend policy of the issuer; (f) Any other material change in the issuer's business or corporate structure; (g) Changes in the issuer's charter, bylaws or instruments corresponding thereto or other actions which may impede the acquisition of control of the issuer by any person; (h) Causing a class of securities of the issuer to be delisted from a national securities exchange or to cease to be authorized to be quoted in an inter-dealer quotation system of a registered national securities association; (i) A class of equity securities of the issuer becoming eligible for termination of registration pursuant to Section 12(g)(4) of the Securities Exchange Act of 1934; or (j) Any action similar to any of those enumerated above. ________________________________________________________________________________ Item 5. Interest in Securities of the Issuer. (a) & (b) Ms. Keon holds sole voting and investment power over 92,854 shares of Common Stock held by the Margaret Lumpkin Keon Trust, under which Ms. Keon serves as trustee. Ms. Keon's beneficial ownership reported herein includes 44,368 shares held by SKL Investment Group, LLC over which shares Ms. Keon has shared voting and investment power. Ms. Keon's beneficial ownership amounts to 137,222 shares of Common Stock, or 4.6% of the outstanding shares. (c) During the past 60 days, Ms. Keon has effected no transactions in the Common Stock other than (i) the disposition on February 9, 2004 of 25,000 shares from the Margaret L. Keon 2002 CRUT, under which Ms. Keon serves as trustee, holding sole voting and investment power, to the Company at $47.50 per share; and (ii) a disposition of 25,000 shares from SKL Investment Group, LLC, over which shares Ms. Keon has shared voting and investment power, to the Company at $47.50 per share on February 9, 2004. (d) Other than the entities described in sub-items (a) & (b) above, to the knowledge of Ms. Keon, no other person has the right to receive or the power to direct the receipt of dividends from, or proceeds from the sale of, the shares of Common Stock beneficially owned by Ms. Keon. (e) Not applicable. ________________________________________________________________________________ Item 6. Contracts, Arrangements, Understandings or Relationships with Respect to Securities of the Issuer. There are no contracts, arrangements, understandings or relationships (legal or otherwise) between Ms. Keon 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. February 9, 2004 ---------------------------------------- (Date) ---------------------------------------- (Signature) Margaret Lumpkin Keon ---------------------------------------- (Name/Title) Attention. Intentional misstatements or omissions of fact constitute federal criminal violations (see 18 U.S.C. 1001). -----END PRIVACY-ENHANCED MESSAGE-----