| Name | Relationship | Address | Signature | Signature date | CIK |
|---|---|---|---|---|---|
| Dively Joseph R | Chairman & CEO, Director | 1421 CHARLESTON AVE, MATTOON | /s/ Matthew K. Smith, attorney-in-fact for Mr. Dively | 05 Dec 2025 | 0001301318 |
| Type | Sym | Class | Transaction | Value $ | Shares | Change % | * Price $ | Shares After | Date | Ownership | Footnotes |
|---|---|---|---|---|---|---|---|---|---|---|---|
| transaction | FMBH | Common Stock | Gift | $0 | -13,309 | -12% | $0.000000 | 98,509 | 03 Dec 2025 | Direct | |
| holding | FMBH | Common Stock | 66,770 | 03 Dec 2025 | By Deferred Compensation Plan |
| Type | Sym | Class | Transaction | Value $ | Shares | Change % | * Price $ | Shares After | Date | Underlying Class | Amount | Exercise Price | Ownership | Footnotes |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| holding | FMBH | Series B 9% Non-cumulative Perpetual Convertible Preferred | 0 | 03 Dec 2025 | Common Stock | 0 | Direct | F1 | ||||||
| holding | FMBH | Series C 8% Non-cumulative Perpetual Convertible Preferred | 0 | 03 Dec 2025 | Common Stock | 0 | Direct | F2 | ||||||
| holding | FMBH | Stock Option | 0 | 03 Dec 2025 | Common Stock | 0 | $27.33 | Direct |
| Id | Content |
|---|---|
| F1 | Each share of the Series B Convertible Preferred Stock (i) is convertible at any time into 231.267 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, and (iii) has no expiration date. |
| F2 | Each 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. |