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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
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 control number. | SEC 1474 (9-02) |
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 Underlying Securities (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 of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Non-Qualified Stock Option (right to buy) | $ 22.5 | 12/16/2004 | M(6) | 2,500 | 02/21/2002 | 02/21/2011 | Common Stock | 2,500 | $ 22.5 | 0 | D | ||||
Non-Qualified Stock Option (right to buy) | $ 28.695 | 12/16/2004 | M(8) | 402 | 02/20/2003 | 02/20/2012 | Common Stock | 402 | $ 28.695 | 1,813 | D | ||||
Non-Qualified Stock Option (right to buy) | $ 36.74 | 12/16/2004 | A(10) | 314 | 06/16/2005 | 02/20/2012 | Common Stock | 314 | $ 0 | 314 | D | ||||
Non-Qualified Stock Option (right to buy) | $ 26.255 | 12/16/2004 | M(7) | 2,342 | 02/19/2004 | 02/19/2013 | Common Stock | 2,342 | $ 26.255 | 0 | D | ||||
Non-Qualified Stock Option (right to buy) | $ 36.74 | 12/16/2004 | A(10) | 1,674 | 06/16/2005 | 02/19/2013 | Common Stock | 1,674 | $ 0 | 1,674 | D | ||||
Non-Qualified Stock Option (right to buy) | $ 36.74 | 12/16/2004 | A(10) | 1,532 | 06/16/2005 | 02/21/2011 | Common Stock | 1,532 | $ 0 | 1,532 | D | ||||
Non-Qualified Stock Option (right to buy) | $ 20.1334 | 12/16/2004 | M(4) | 1,594 | 11/19/1998 | 11/19/2007 | Common Stock | 1,594 | $ 20.1334 | 0 | D | ||||
Non-Qualified Stock Option (right to buy) | $ 36.74 | 12/16/2004 | A(10) | 874 | 06/16/2005 | 11/19/2007 | Common Stock | 874 | $ 0 | 874 | D | ||||
Non-Qualified Stock Option (right to buy) | $ 21.7 | 12/16/2004 | M(5) | 854 | 02/18/1999 | 02/18/2008 | Common Stock | 854 | $ 21.7 | 0 | D | ||||
Non-Qualified Stock Option (right to buy) | $ 36.74 | 12/16/2004 | A(10) | 505 | 06/16/2005 | 02/18/2008 | Common Stock | 505 | $ 0 | 505 | D | ||||
Non-Qualified Stock Option (right to buy) | $ 18.55 | 12/16/2004 | M(2) | 998 | 02/17/2000 | 02/17/2009 | Common Stock | 998 | $ 18.55 | 0 | D | ||||
Non-Qualified Stock Option (right to buy) | $ 36.74 | 12/16/2004 | A(10) | 504 | 06/16/2005 | 02/17/2009 | Common Stock | 504 | $ 0 | 504 | D | ||||
Non-Qualified Stock Option (right to buy) | $ 18.4 | 12/16/2004 | 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) | $ 36.74 | 12/16/2004 | A(10) | 504 | 06/16/2005 | 02/16/2010 | Common Stock | 504 | $ 0 | 504 | D | ||||
Non-Qualified Stock Option (right to buy) | $ 18.875 | 12/16/2004 | M(3) | 2,011 | 05/17/2001 | 05/17/2010 | Common Stock | 2,011 | $ 18.875 | 0 | D | ||||
Non-Qualified Stock Option (right to buy) | $ 36.74 | 12/16/2004 | A(10) | 1,034 | 06/16/2005 | 05/17/2010 | Common Stock | 1,034 | $ 0 | 1,034 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
EDWARDS O RALPH 300 PARK BOULEVARD, SUITE 400 ITASCA, IL 60143 |
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By: Steven H. Shapiro, Attorney in-fact for | 12/20/2004 | |
**Signature of Reporting Person | Date |
* | 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). |
(1) | The transaction represents the exercise of 1,005 stock options under the Non-Employee Directors' Stock Option Plan whereby 504 previously acquired shares were tendered as payment of the exercise price with the resulting value realized being deferred into the Nonqualified Gain Deferral Plan in the form of 501shares. |
(2) | The transaction represents the exercise of 998 stock options under the Non-Employee Directors' Stock Option Plan whereby 504 previously acquired shares were tendered as payment of the exercise price with the resulting value realized being deferred into the Nonqualified Gain Deferral Plan in the form of 494 shares. |
(3) | The transaction represents the exercise of 2,011 stock options under the Non-Employee Directors' Stock Option Plan whereby 1,034 previously acquired shares were tendered as payment of the exercise price with the resulting value realized being deferred into the Nonqualified Gain Deferral Plan in the form of 977shares. |
(4) | The transaction represents the exercise of 1,594 stock options under the Non-Employee Directors' Stock Option Plan whereby 874 previously acquired shares were tendered as payment of the exercise price with the resulting value realized being deferred into the Nonqualified Gain Deferral Plan in the form of 720 shares. |
(5) | The transaction represents the exercise of 854 stock options under the Non-Employee Directors' Stock Option Plan whereby 505 previously acquired shares were tendered as payment of the exercise price with the resulting value realized being deferred into the Nonqualified Gain Deferral Plan in the form of 349 shares. |
(6) | The transaction represents the exercise of 2,500 stock options under the Non-Employee Directors' Stock Option Plan whereby 1,532 previously acquired shares were tendered as payment of the exercise price with the resulting value realized being deferred into the Nonqualified Gain Deferral Plan in the form of 968 shares. |
(7) | The transaction represents the exercise of 2,342 stock options under the Non-Employee Directors' Stock Option Plan whereby 1,674 previously acquired shares were tendered as payment of the exercise price with the resulting value realized being deferred into the Nonqualified Gain Deferral Plan in the form of 668 shares. |
(8) | The transaction represents the exercise of 402 stock options under the Non-Employee Directors' Stock Option Plan whereby 314 previously acquired shares were tendered as payment of the exercise price with the resulting value realized being deferred into the Nonqualified Gain Deferral Plan in the form of 88 shares. |
(9) | Between February 25, 2004 and December 17, 2004 the reporting person acquired 61 shares of First Midwest common stock under the First Midwest Bancorp, Inc. Dividend Reinvestment Plan. The information in this report is based on a plan statement dated October 19, 2004. |
(10) | 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 12/16/04. |