-----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, L0lKwa20EuzVUo8Mt8Lw2vkTj9Nt9xJlalfPv4EcCP4cThBOOKoeME7VBW9QZ9dv EcRPlhzvTyT+vn7rh3MUMw== 0000950144-99-001562.txt : 19990215 0000950144-99-001562.hdr.sgml : 19990215 ACCESSION NUMBER: 0000950144-99-001562 CONFORMED SUBMISSION TYPE: SC 13G/A PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 19990212 GROUP MEMBERS: DMAR L P GROUP MEMBERS: ESTATE OF DAN W MADDOX GROUP MEMBERS: ROBIN G COSTA 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 STATE OF INCORPORATION: TN FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G/A SEC ACT: SEC FILE NUMBER: 005-53347 FILM NUMBER: 99534618 BUSINESS ADDRESS: STREET 1: 111 WESTWOOD PLACE STREET 2: SUITE 402 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/A 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/A 1 AMERICAN RETIREMENT CORPORATION/ 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) (Amendment No. 1) American Retirement Corporation ------------------------------------------------------------------------------- (Name of Issuer) Common Stock ------------------------------------------------------------------------------- (Title of Class of Securities) 028913 10 1 ------------------------------------------------------------------------------- (CUSIP Number) December 31, 1998 ------------------------------------------------------------------------------- (Date of Event Which Requires Filing of this Statement) Check the following box to designate the rule pursuant to which this Schedule is filed: [ ] Rule 13d-1(b) [ ] Rule 13d-(c) [X] Rule 13d-1(d) 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 --------------------------------------------------------------------- (5) SOLE VOTING POWER NUMBER OF 5,000 SHARES -------------------------------------------------------- BENEFICIALLY (6) SHARED VOTING POWER OWNED BY 1,380,037 EACH -------------------------------------------------------- REPORTING (7) SOLE DISPOSITIVE POWER PERSON WITH 5,000 -------------------------------------------------------- (8) SHARED DISPOSITIVE POWER 1,380,037 -------------------------------------------------------- (9) AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 1,385,037 --------------------------------------------------------------------- (10) CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES* (A) [ ] --------------------------------------------------------------------- (11) PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 8.1% --------------------------------------------------------------------- (12) TYPE OF REPORTING PERSON* IN --------------------------------------------------------------------- *SEE INSTRUCTIONS BEFORE FILLING OUT! 3 CUSIP NO. 028913 10 1 13G PAGE 3 OF 7 PAGES (1) NAME OF REPORTING PERSON I.R.S. IDENTIFICATION NO. OF ABOVE PERSON (ENTITIES ONLY) Estate of Dan W. 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 --------------------------------------------------------------------- (5) SOLE VOTING POWER NUMBER OF 0 SHARES -------------------------------------------------------- BENEFICIALLY (6) SHARED VOTING POWER OWNED BY 0 EACH -------------------------------------------------------- REPORTING (7) SOLE DISPOSITIVE POWER PERSON WITH 0 -------------------------------------------------------- (8) SHARED DISPOSITIVE POWER 0 -------------------------------------------------------- (9) AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 0 --------------------------------------------------------------------- (10) CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES* (A) [ ] --------------------------------------------------------------------- (11) PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 0% --------------------------------------------------------------------- (12) TYPE OF REPORTING PERSON* IN --------------------------------------------------------------------- *SEE INSTRUCTIONS BEFORE FILLING OUT! 4 CUSIP NO. 028913 10 1 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 --------------------------------------------------------------------- (5) SOLE VOTING POWER NUMBER OF 1,372,037 SHARES -------------------------------------------------------- BENEFICIALLY (6) SHARED VOTING POWER OWNED BY 0 EACH -------------------------------------------------------- REPORTING (7) SOLE DISPOSITIVE POWER PERSON WITH 1,372,037 -------------------------------------------------------- (8) SHARED DISPOSITIVE POWER 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 8.0% --------------------------------------------------------------------- (12) TYPE OF REPORTING PERSON* PN --------------------------------------------------------------------- *SEE INSTRUCTIONS 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 Person Filing: Robin G. Costa ("Costa") DMAR Limited Partnership ("DMAR") Estate of Dan W. 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 is a United States citizen 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 1,385,037(2) 8.1% 5,000 1,380,037 5,000 1,380,037 Maddox -- -- -- -- -- -- DMAR 1,372,037(3) 8.0% 1,372,037 -- 1,372,037 --
---------------- (1) Based on 17,117,553 shares of Common Stock outstanding as of December 31, 1998. (2) Includes 1,372,037 shares beneficially owned by DMAR, 5,000 shares subject to currently exercisable options, and an aggregate of 8,000 shares beneficially owned by trusts for which Costa serves as trust advisor. Costa is President of Margaret Energy, Inc., the general partner of DMAR. Costa exercises voting and dispositive power over the shares held by the trusts. Item 5. Ownership of Five Percent or Less of a Class. If this statement is being filed to report the fact that as of the date hereof the reporting person has ceased to be the beneficial owner of more than five percent of the class of securities, check the following [X].* * The Estate of Dan Maddox does not own greater than 5% of the class of securities. 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 ----------------------------------------- Estate of Dan W. Maddox /s/ Robin G. Costa ----------------------------------------- By: Robin G. Costa Co-Executor DMAR Limited Partnership /s/ Robin G. Costa ----------------------------------------- By: Margaret Energy, Inc., Its General Partner By: Robin G. Costa, Its President
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