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) 12/28/2004 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed
(Month/Day/Year) 12/30/2004 |
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 | 12/28/2004 | M(1) | 413 | A | $22.4 | 81,375 | D | |||
Common Stock | 12/28/2004 | M(1) | 998 | A | $18.55 | 82,373 | D | |||
Common Stock | 12/28/2004 | M(1) | 1,005 | A | $18.4 | 83,378 | D | |||
Common Stock | 12/28/2004 | M(1) | 2,011 | A | $18.875 | 85,389 | D | |||
Common Stock | 12/28/2004 | M(1) | 2,500 | A | $22.5 | 87,889 | D | |||
Common Stock | 12/28/2004 | M(1) | 2,215 | A | $28.695 | 90,104 | D | |||
Common Stock | 12/28/2004 | M(1) | 2,342 | A | $26.255 | 92,446 | D | |||
Common Stock | 12/28/2004 | F(1) | 252 | D | $0 | 92,194 | D | |||
Common Stock | 12/28/2004 | F(1) | 503 | D | $0 | 91,691 | D | |||
Common Stock | 12/28/2004 | F(1) | 503 | D | $0 | 91,188 | D | |||
Common Stock | 12/28/2004 | F(1) | 1,031 | D | $0 | 90,157 | D | |||
Common Stock | 12/28/2004 | F(1) | 1,528 | D | $0 | 88,629 | D | |||
Common Stock | 12/28/2004 | F(1) | 1,727 | D | $0 | 86,902 | D | |||
Common Stock | 12/28/2004 | F(1) | 1,670 | D | $0 | 85,232 | D |
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) | $22.4 | 12/28/2004 | M(1) | 413 | 08/19/1999 | 08/19/2008 | Common Stock | 413 | $22.4 | 0 | D | ||||
Non-Qualified Stock Option (right to buy) | $36.82 | 12/28/2004 | A(2) | 252 | 06/28/2005 | 08/19/2008 | Common Stock | 252 | $0 | 252 | D | ||||
Non-Qualified Stock Option (right to buy) | $18.55 | 12/28/2004 | M(1) | 998 | 02/17/2000 | 02/17/2009 | Common Stock | 998 | $18.55 | 0 | D | ||||
Non-Qualified Stock Option (right to buy) | $36.82 | 12/28/2004 | A(2) | 503 | 06/28/2005 | 02/17/2009 | Common Stock | 503 | $0 | 503 | D | ||||
Non-Qualified Stock Option (right to buy) | $18.4 | 12/28/2004 | M(1) | 1,005 | 02/16/2001 | 02/16/2010 | Common Stock | 1,005 | $18.4 | 0 | D | ||||
Non-Qualified Stock Option (right to buy) | $36.82 | 12/28/2004 | A(2) | 503 | 06/28/2005 | 02/16/2010 | Common Stock | 503 | $0 | 503 | D | ||||
Non-Qualified Stock Option (right to buy) | $18.875 | 12/28/2004 | M(1) | 2,011 | 05/17/2001 | 05/17/2010 | Common Stock | 2,011 | $18.875 | 0 | D | ||||
Non-Qualified Stock Option (right to buy) | $36.82 | 12/28/2004 | A(2) | 1,031 | 06/28/2005 | 05/17/2010 | Common Stock | 1,031 | $0 | 1,031 | D | ||||
Non-Qualified Stock Option (right to buy) | $22.5 | 12/28/2004 | M(1) | 2,500 | 02/21/2002 | 02/21/2011 | Common Stock | 2,500 | $22.5 | 0 | D | ||||
Non-Qualified Stock Option (right to buy) | $36.82 | 12/28/2004 | A(2) | 1,528 | 06/28/2005 | 02/21/2011 | Common Stock | 1,528 | $0 | 1,528 | D | ||||
Non-Qualified Stock Option (right to buy) | $28.695 | 12/28/2004 | M(1) | 2,215 | 02/20/2003 | 02/20/2012 | Common Stock | 2,215 | $28.695 | 0 | D | ||||
Non-Qualified Stock Option (right to buy) | $36.82 | 12/28/2004 | A(2) | 1,727 | 06/28/2005 | 02/20/2012 | Common Stock | 1,727 | $0 | 1,727 | D | ||||
Non-Qualified Stock Option (right to buy) | $26.255 | 12/28/2004 | M(1) | 2,342 | 02/19/2004 | 02/19/2013 | Common Stock | 2,342 | $26.255 | 0 | D | ||||
Non-Qualified Stock Option (right to buy) | $36.82 | 12/28/2004 | A(2) | 1,670 | 06/28/2005 | 02/19/2013 | Common Stock | 1,670 | $0 | 1,670 | D |
Explanation of Responses: |
1. Corrects previous filing on December 30, 2004, which showed the reporting person's exercise of stock options, tender of previously acquired shares to the issuer and holdings in a Non-Qualified Gain Deferral Plan account. This filing supersedes the December 30, 2004 filing and shows the exercise of 11,484 stock options under the Non-Employee Directors' Stock Option Plan whereby 7,214 previously acquired shares were tendered as payment of the exercise price with the resulting net shares held in direct ownership. |
2. The transaction represents a reload stock option granted under the Non-Employee Directors' Stock Option Plan to replace the number of shares tendered in the option exercised on 12/28/04. |
Remarks: |
By: Andrea L. Stangl, Attorney-in-fact for | 01/20/2005 | |
** 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. |