-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, UuPSZStoUHRQa92xF+xmNQDbBJlt6JJ+KNeexkU+m/mTnLUXg2vPFgVTO6N9/1pa PN4NVrSIYo/WkkPCeCq73Q== 0000950144-98-001604.txt : 19980218 0000950144-98-001604.hdr.sgml : 19980218 ACCESSION NUMBER: 0000950144-98-001604 CONFORMED SUBMISSION TYPE: SC 13G PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 19980213 SROS: NYSE SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: AMERICAN RETIREMENT CORP CENTRAL INDEX KEY: 0000787784 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-SKILLED NURSING CARE FACILITIES [8051] IRS NUMBER: 621674303 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G SEC ACT: SEC FILE NUMBER: 005-53347 FILM NUMBER: 98540165 BUSINESS ADDRESS: STREET 1: 111 WESTWOOD PLACE CITY: BRENTWOOD STATE: TN ZIP: 37027 BUSINESS PHONE: 6152212250 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: DMAR L P CENTRAL INDEX KEY: 0001055494 STANDARD INDUSTRIAL CLASSIFICATION: [] FILING VALUES: FORM TYPE: SC 13G BUSINESS ADDRESS: STREET 1: 3633 CLEGHORN AVE STREET 2: STE 400 CITY: NASHVILLE STATE: TN ZIP: 37215 BUSINESS PHONE: 6152212259 MAIL ADDRESS: STREET 1: 3633 CLEGHORN AVE STREET 2: STE 400 CITY: NASHVILLE STATE: TN ZIP: 37215 SC 13G 1 AMERICAN RETIREMENT CORP./DMAR 1 SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 ---------------------------------- SCHEDULE 13G (Rule 13d-102) INFORMATION TO BE INCLUDED IN STATEMENTS FILED PURSUANT TO RULES 13D-1(b) AND (c) AND AMENDMENTS THERETO FILED PURSUANT TO 13D-2(b) American Retirement Corporation - ------------------------------------------------------------------------------- (Name of Issuer) Common Stock - ------------------------------------------------------------------------------- (Title of Class of Securities) 028913 10 1 ------------------------------------------- (CUSIP Number) Page 1 of 7 Pages 2 - --------------------- ----------------- CUSIP No. 028913 10 1 13G Page 2 of 7 Pages - --------------------- ----------------- - ------------------------------------------------------------------------------- 1 NAME OF REPORTING PERSON I.R.S. IDENTIFICATION NO. OF ABOVE PERSON (ENTITIES ONLY) Robin G. Costa - ------------------------------------------------------------------------------- 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a) [ ] (b) [ ] - ------------------------------------------------------------------------------- 3 SEC USE ONLY - ------------------------------------------------------------------------------- 4 CITIZENSHIP OR PLACE OF ORGANIZATION United States - ------------------------------------------------------------------------------- NUMBER OF 5 SOLE VOTING POWER SHARES 0 ---------------------------------------------------------- BENEFICIALLY 6 SHARED VOTING POWER OWNED BY 1,438,259 ---------------------------------------------------------- EACH 7 SOLE DISPOSITIVE POWER REPORTING 0 ---------------------------------------------------------- PERSON 8 SHARED DISPOSITIVE POWER WITH 1,438,259 - ------------------------------------------------------------------------------- 9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 1,438,259 - ------------------------------------------------------------------------------- 10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES* (a) [ ] - ------------------------------------------------------------------------------- 11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 12.6% - ------------------------------------------------------------------------------- 12 TYPE OF REPORTING PERSON* IN - ------------------------------------------------------------------------------- *SEE INSTRUCTION BEFORE FILLING OUT! 3 ----------------- 13G Page 3 of 7 Pages ----------------- - ------------------------------------------------------------------------------- 1 NAME OF REPORTING PERSON I.R.S. IDENTIFICATION NO. OF ABOVE PERSON (ENTITIES ONLY) Dan Maddox - ------------------------------------------------------------------------------- 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a) [ ] (b) [ ] - ------------------------------------------------------------------------------- 3 SEC USE ONLY - ------------------------------------------------------------------------------- 4 CITIZENSHIP OR PLACE OF ORGANIZATION United States - ------------------------------------------------------------------------------- NUMBER OF 5 SOLE VOTING POWER SHARES 0 --------------------------------------------------------- BENEFICIALLY 6 SHARED VOTING POWER OWNED BY 1,438,259 --------------------------------------------------------- EACH 7 SOLE DISPOSITIVE POWER REPORTING 0 --------------------------------------------------------- PERSON 8 SHARED DISPOSITIVE POWER WITH 1,438,259 - ------------------------------------------------------------------------------- 9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 1,438,259 - ------------------------------------------------------------------------------- 10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES* (a) [ ] - ------------------------------------------------------------------------------- 11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 12.6% - ------------------------------------------------------------------------------- 12 TYPE OF REPORTING PERSON* IN - ------------------------------------------------------------------------------- *SEE INSTRUCTION BEFORE FILLING OUT! 4 ----------------- 13G Page 4 of 7 Pages ----------------- - ------------------------------------------------------------------------------- 1 NAME OF REPORTING PERSON I.R.S. IDENTIFICATION NO. OF ABOVE PERSON (ENTITIES ONLY) DMAR Limited Partnership (IRS Employer Identification No. 75-2384625) - ------------------------------------------------------------------------------- 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a) [ ] (b) [ ] - ------------------------------------------------------------------------------- 3 SEC USE ONLY - ------------------------------------------------------------------------------- 4 CITIZENSHIP OR PLACE OF ORGANIZATION State of Texas - ------------------------------------------------------------------------------- NUMBER OF 5 SOLE VOTING POWER SHARES 1,372,037 --------------------------------------------------------- BENEFICIALLY 6 SHARED VOTING POWER OWNED BY 0 --------------------------------------------------------- EACH 7 SOLE DISPOSITIVE POWER REPORTING 1,372,037 --------------------------------------------------------- PERSON 8 SHARED DISPOSITIVE POWER WITH 0 - ------------------------------------------------------------------------------- 9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 1,372,037 - ------------------------------------------------------------------------------- 10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES* (a) [ ] - ------------------------------------------------------------------------------- 11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 12.0% - ------------------------------------------------------------------------------- 12 TYPE OF REPORTING PERSON* PN - ------------------------------------------------------------------------------- *SEE INSTRUCTION BEFORE FILLING OUT! 5 Page 5 of 7 Pages SCHEDULE 13G Item 1(a). Name of Issuer: American Retirement Corporation ("ACR") Item 1(b). Address of Issuer's 111 Westwood Place, Suite 402 Principal Executive Brentwood, Tennessee 37027 Offices: Item 2(a). Name of Persons Filing: Robin G. Costa ("Costa") DMAR Limited Partnership ("DMAR") Dan Maddox ("Maddox") Item 2(b). Address of Principal 3833 Cleghorn Avenue Business Office: Suite 400 Nashville, Tennessee 37215 is the business address for each of Costa, DMAR, and Maddox. Item 2(c). Organization/Citizenship: Costa and Maddox are each United States citizens and DMAR is a Texas limited partnership. Item 2(d). Title of Class Common stock of Securities: ("Common Stock") Item 2(e). CUSIP Number: 028913 10 1 Item 3. Inapplicable. Item 4. Ownership. This Schedule 13G is filed jointly by the reporting persons to reflect beneficial ownership of Common Stock by Costa, Maddox, and DMAR and certain overlapping beneficial ownership of such persons. 6 Page 6 of 7 Pages
Total Shares Shared of ACR Common Percent Sole Shared Sole Power Stock Beneficially of Voting Voting Power to to Person Owned Class(1) Power Power Dispose Dispose - ------ ------------------ -------- ------- ------- --------- -------- Costa 1,438,259(2) 12.6% -- 1,438,259 -- 1,438,259 Maddox 1,438,259(3) 12.6% -- 1,438,259 -- 1,438,259 DMAR 1,372,037(4) 12.0% 1,372,037 -- 1,372,037 --
- ------------ (1) Based on 11,420,860 shares of Common Stock outstanding as of December 31, 1997. (2) Includes 1,372,037 shares beneficially owned by DMAR, an aggregate of 18,000 shares beneficially owned by trusts for the benefit of certain members of Maddox's family, and 48,222 shares beneficially owned by Maddox individually. Costa is a Vice President of Margaret Energy, Inc., the general partner of DMAR. The partners in DMAR include trusts and corporations owned by, or for the benefit of, Maddox and his wife. Maddox and Costa exercise voting and dispositive power over the shares held by the trusts and the shares held by Maddox individually. (3) Includes 1,372,037 shares beneficially owned by DMAR, an aggregate of 18,000 shares beneficially owned by trusts for the benefit of certain members of Maddox's family, and 48,222 shares beneficially owned by Maddox individually. See Note (2). (4) The partners in DMAR include corporations and trusts owned by, or for the benefit of, Maddox and his wife. Item 5. Ownership of Five Percent or Less of a Class. Inapplicable. Item 6. Ownership of More than Five Percent on Behalf of Another Person. Inapplicable. Item 7. Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on by the Parent Holding Company. Inapplicable. Item 8. Identification and Classification of Members of the Group. Inapplicable. Item 9. Notice of Dissolution of Group. Inapplicable. Item 10. Certification. Inapplicable. 7 Page 7 of 7 Pages SIGNATURES After reasonable inquiry and to the best of the knowledge and belief of each of the undersigned, each of the undersigned certify that the information set forth in this statement is true, complete, and correct. Robin G. Costa /s/ Robin G. Costa ------------------------------------- Dan Maddox /s/ Robin G. Costa ------------------------------------- By: Robin G. Costa Co-Executor of Maddox's Estate* DMAR Limited Partnership /s/ Robin G. Costa ------------------------------------ By: Margaret Energy, Inc., Its General Partner By: Robin G. Costa, Its Vice President *Maddox passed away in January 1998. -----END PRIVACY-ENHANCED MESSAGE-----