-----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, FH1ty3WQQtOf8Bpf8geg5BbH0HsGJOVJY4rQzPJUlWh2qh0GBJS7GqBXMv7jo8uV jjPoGkmKVMGEwbkjwtUWiw== 0000700565-03-000168.txt : 20030821 0000700565-03-000168.hdr.sgml : 20030821 20030821173953 ACCESSION NUMBER: 0000700565-03-000168 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20030821 FILED AS OF DATE: 20030821 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 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BURICH CHRISTIE L CENTRAL INDEX KEY: 0001185503 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-13368 FILM NUMBER: 03860921 BUSINESS ADDRESS: STREET 1: 1515 CHARLESTON AVE CITY: MATTOON STATE: IL ZIP: 61938 BUSINESS PHONE: 2172580493 MAIL ADDRESS: STREET 1: 11 OAK POINTE DRIVE CITY: NEOGA STATE: IL ZIP: 62447 4 1 form4_burich-082103ex.xml X0201 4 2003-08-21 0 0000700565 FIRST MID ILLINOIS BANCSHARES INC FMBH.OB 0001185503 BURICH CHRISTIE L 11 OAK POINTE DRIVE NEOGA IL 62447 0 1 0 0 Vice President Common Stock 2003-06-13 5 J 0 3.211 29.20 A 378.211 D Common Stock 2003-05-14 5 P 0 8.412 28.95 A 1515.707 I By 401K Common Stock 2003-06-13 5 J 0 12.961 29.20 A 1528.668 I By 401K Stock Options 24.00 2003-01-01 2011-12-18 Common Stock 1125 1125 D Stock Option 27.25 2004-01-01 2012-12-16 Common Stock 1500 2625 D Shares purchased through the company's dividend reinvestment plan with dividends paid on shares of common stock held. Options become exercisable in 4 equal annual installments beginning 1/1/2003. Options become exercisable in 4 equal annual installments beginning 1/1/2004. Michael L. Taylor, Pursuant to a Power of Attorney filed on 12/19/02. 2003-08-21 -----END PRIVACY-ENHANCED MESSAGE-----