SEC Form 4 · accession 0001127602-16-062557
FIRST MID BANCSHARES, INC. · FMBH
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Robert S Cook
Director
Period of report
Sep 8, 2016
Accepted (ET)
Sep 15, 2016 · 4:05 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 StockF1 | Sep 8, 2016 | A | 1,980 | — | A | 1,980 | I | As Custodian for Children |
| Common StockF2 | Sep 8, 2016 | A | 1,386 | — | A | 1,386 | I | by 401k |
| Common StockF3,F4 | Sep 8, 2016 | A | 5,654 | — | A | 5,654 | I | By LLC |
| Common StockF5 | Sep 8, 2016 | A | 244 | — | A | 244 | I | By Spouse |
| Common Stock | holding | — | — | — | 14,122 | D |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1Received in exchange for 4,000 shares of First Clover Leaf Financial Corp. common stock in connection with merger of First Clover Leaf Financial Corp. into First Mid Illinois Bancshares, Inc. (the "Merger"). On the effective date of the Merger, the closing price of First Clover Leaf Financial Corporation's common stock was $12.50 per share, and the closing price of First Mid Illinois Bancshares, Inc. common stock was $25.35 per share.
- F2Received in exchange for 2,800 shares of First Clover Leaf Financial Corp. common stock in connection with merger of First Clover Leaf Financial Corp. into First Mid Illinois Bancshares, Inc. (the "Merger"). On the effective date of the Merger, the closing price of First Clover Leaf Financial Corporation's common stock was $12.50 per share, and the closing price of First Mid Illinois Bancshares, Inc. common stock was $25.35 per share.
- F3Received in exchange for 11,423 shares of First Clover Leaf Financial Corp. common stock in connection with merger of First Clover Leaf Financial Corp. into First Mid Illinois Bancshares, Inc. (the "Merger"). On the effective date of the Merger, the closing price of First Clover Leaf Financial Corporation's common stock was $12.50 per share, and the closing price of First Mid Illinois Bancshares, Inc. common stock was $25.35 per share.
- F4Reflects transactions not required to be reported pursuant to Section 16 of the Securities Exchange Act of 1934, as amended.
- F5Received in exchange for 493 shares of First Clover Leaf Financial Corp. common stock in connection with merger of First Clover Leaf Financial Corp. into First Mid Illinois Bancshares, Inc. (the "Merger"). On the effective date of the Merger, the closing price of First Clover Leaf Financial Corporation's common stock was $12.50 per share, and the closing price of First Mid Illinois Bancshares, Inc. common stock was $25.35 per share.