-----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, AxeMjLVNSq7Xo3Do8zmjs3AfqrXspAi+cqcx+XH8XVEG7Y8obIiJ26IJEEOiV00c TgxLm1l54JAttWUXmhx4xg== 0001040441-04-000104.txt : 20040706 0001040441-04-000104.hdr.sgml : 20040705 20040706162012 ACCESSION NUMBER: 0001040441-04-000104 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040520 FILED AS OF DATE: 20040706 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: BEVERLY ENTERPRISES INC CENTRAL INDEX KEY: 0001040441 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-SKILLED NURSING CARE FACILITIES [8051] IRS NUMBER: 621691861 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: ONE THOUSAND BEVERLY WAY CITY: FORT SMITH STATE: AR ZIP: 72919 BUSINESS PHONE: 5014526712 MAIL ADDRESS: STREET 1: ONE THOUSAND BEVERLY WAY CITY: FORT SMITH STATE: AR ZIP: 72919 FORMER COMPANY: FORMER CONFORMED NAME: NEW BEVERLY HOLDINGS INC DATE OF NAME CHANGE: 19970604 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: HOLIDAY EDITH E CENTRAL INDEX KEY: 0001015844 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-09550-2B FILM NUMBER: 04902604 BUSINESS ADDRESS: STREET 1: 3239 38TH STREET NW CITY: WASHINGTON STATE: DC ZIP: 20016 BUSINESS PHONE: 4153126505 MAIL ADDRESS: STREET 1: FRANKLIN RESOURCES INC STREET 2: 901 MARINERS ISLAND BLVD 6TH FL CITY: SAN MATEO STATE: CA ZIP: 94404 4 1 edgardoc.xml PRIMARY DOCUMENT X0202 4 2004-05-20 1 0001040441 BEVERLY ENTERPRISES INC BEV 0001015844 HOLIDAY EDITH E ONE THOUSAND BEVERLY WAY FORT SMITH AR 72919 1 0 0 0 PHANTOM STOCK UNITS 2004-05-20 4 D 0 23427.4383 7.8 D 2004-05-20 $.10 Par Value Common Stock 23427.4383 0 D These units of phantom stock have been granted under the Non-Employee Director Deferred Compensation Plan and are credited to a deferred share unit account each month, together with a 25% Company match, to be paid to the director, or, in the case of his/her death prior to retirement from the Board, his/her beneficiary(ies), in stock (or, with the Board's approval, in cash) upon his/her retirement from the Board, death or disability. Each Deferred Share Unit has a value equal to one share of common stock of Beverly. Phantom stock units settled in cash upon retirement from the Board. By: MONA BRANNON For: EDITH E HOLIDAY 2004-07-06 -----END PRIVACY-ENHANCED MESSAGE-----