SEC Form 4 · accession 0001127602-16-052439
FIRST MID BANCSHARES, INC. · FMBH
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Steven L Grissom
Director
Period of report
May 16, 2016
Accepted (ET)
May 17, 2016 · 1:45 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000700565
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock | May 16, 2016 | C | 19,714 | $20.29 | A | 19,714 | I | By Spouse |
| Common Stock | holding | — | — | — | 69,797 | D | ||
| Common Stock | holding | — | — | — | 2,518 | I | By Deferred Comp Plan |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Series C 8% Non-cumulative Perpetual Convertible PreferredF2 | — | May 16, 2016 | C | 80 | D | — | — | Common Stock | 19,714 | 0 | I |
Explanation of responses
- F1On May 16, 2016 the Company caused the conversion of the Series C 8% Non-cumulative Perpetual Convertible Preferred stock. Each share was converted into 246.4268 shares of common stock, cash in lieu of fractional shares.
- F2Each Share of Series C Convertible Preferred Stock (i) is convertible at any time into 246.427 shares of common stock and cash in lieu of any fractional share of common stock, subject to certain adjustments, (ii) is convertible at First Mid-Illinois Bancshares' option under certain circumstances, (iii) has no expiration date.