|
FORM 4
[ ] Check this box if no longer
subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). |
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, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
OMB APPROVAL
OMB Number: 3235-0287
Expires: January 31, 2005
Estimated average burden hours per response. . . . . 0.5 |
|
1. Name and Address of Reporting Person*
Miller, Alan B.
(Last) (First) (Middle)
367 South Gulph Road
(Street)
King of Prussia, PA 19406
(City) (State) (Zip)
|
2. Issuer Name and Ticker or Trading Symbol Universal Health Services, Inc.
3. I.R.S. Identification
Number of Reporting Person, if an entity (voluntary) |
4. Statement for Month/Day/Year 10/23/2002
5. If Amendment, Date of Original (Month/Day/Year) |
6. Relationship of Reporting Person(s) to Issuer
(Check all applicable) X Director
X 10% Owner
X Officer (give title below)
Other (specify below)
Description
Chairman, President, CEO
7. Individual or Joint/Group
Filing (Check Applicable Line) X Form filed by One Reporting Person
Form filed by More than One Reporting Person
|
|
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
|
|||||||||||||||
|
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. Owner-
ship Form: Direct (D) or Indirect (I) (Instr. 4) |
7. Nature of
Indirect Beneficial Ownership (Instr. 4) |
||||||||
|
Code
|
V
|
Amount
|
A/D
|
Price
|
|||||||||||
|
Class A convertible to Class B - The Miller Family Charitable Trust
|
10/23/2002
|
|
Z
|
|
181,818
|
A
|
$
|
|
I
|
Alan B. Miller, as Sole Trustee
|
|||||
|
Class C convertible to Class B - The Miller Family Charitable Trust
|
10/23/2002
|
|
Z
|
|
18,182
|
A
|
$
|
200,000
|
I
|
Alan B. Miller, as Sole Trustee
|
|||||
|
Class A convertible to Class B - The Miller Family Charitable Trust
|
10/23/2002
|
|
C
|
|
181,818
|
D
|
$
|
|
I
|
Alan B. Miller, as Sole Trustee
|
|||||
|
Class C convertible to Class B - The Miller Family Charitable Trust
|
10/23/2002
|
|
C
|
|
18,182
|
D
|
$
|
None
|
I
|
Alan B. Miller, as Sole Trustee
|
|||||
|
Class A convertible to Common B
|
10/23/2002
|
|
C
|
|
338,664
|
D
|
$
|
|
D
|
|
|||||
|
Class C convertible to Common B
|
10/23/2002
|
|
C
|
|
33,866
|
D
|
$
|
|
D
|
|
|||||
|
Common B
|
10/23/2002
|
|
S
|
|
200,000
|
D
|
$54.00
|
|
D
|
|
|||||
|
Common B
|
10/23/2002
|
|
S
|
|
372,530
|
D
|
$54.00
|
|
D
|
|
|||||
|
Common B
|
10/23/2002
|
|
S
|
|
495,126
|
D
|
$54.00
|
584,334
|
D
|
|
|||||
|
Common B - Alan B. Miller Family Foundation
|
10/23/2002
|
|
S
|
|
100,000
|
D
|
$54.00
|
28,000
|
D
|
|
|||||
|
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
|
|||||||||||||||
|
1. Title of Derivative Security
(Instr. 3) |
2. Conver-
sion or Exercise Price of Deri- vative 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(DE) and
Expiration Date(ED) (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. Owner- ship Form of Deriv- ative Securities: Direct (D) or Indirect (I) (Instr.4) |
11. Nature of Indirect Beneficial Ownership (Instr.4) |
||||
|
Code
|
V
|
A
|
D
|
DE
|
ED
|
Title
|
Amount or Number of Shares
| ||||||||
|
|
|
|
|
|
|
|
|
|
|||||||
| Common A | $ | 10/23/2002 |
Z
|
|
181,818 |
|
|
181,818
|
Common B
|
$
|
1,925,964
|
D
|
|||
| Common C | $ | 10/23/2002 |
Z
|
|
18,182 |
|
|
18,182
|
Common B
|
$
|
364,710
|
D
|
|||
| Miller Family Charitable Trust | $ | 10/23/2002 |
C
|
|
200,000 |
|
|
200,000
|
Common B
|
$
|
200,000
|
I
|
(1) | ||
| Common A | $ | 10/23/2002 |
C
|
|
338,664 |
|
|
338,664
|
Common B
|
$
|
1,587,300
|
D
|
|||
| Common C | $ | 10/23/2002 |
C
|
|
33,866 |
|
|
33,886
|
Common B
|
$
|
330,844
|
D
|
|||
| The Miller Family Charitable Trust | $54.00 | 10/23/2002 |
S
|
|
200,000 |
|
|
200,000
|
Common B
|
$54.00
|
None
|
I
|
(1) | ||
| Alan B. Miller Family Foundation | $54.00 | 10/23/2002 |
S
|
|
100,000 |
|
|
100,000
|
Common B
|
$54.00
|
28,000
|
I
|
Trustee | ||
| |
|
(1) Alan B. Miller, Sole Trustee of The Miller Family Charitable Trust
|
|
By: /s/ Alan B. Miller 10/25/2002 ** Signature of Reporting Person Date SEC 1474 (8-02) |
|
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. Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |