-----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, SrVfkAQOGxDS2OkfLF8u81YveiVVhjezYjEVKYTG84AHfdZCtYo2DuKsyqaAIvXh uB20nMflq3nuX8pa0CHFfg== 0001040441-04-000105.txt : 20040706 0001040441-04-000105.hdr.sgml : 20040705 20040706162106 ACCESSION NUMBER: 0001040441-04-000105 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040701 FILED AS OF DATE: 20040706 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SABEL IVAN R CENTRAL INDEX KEY: 0001217563 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-09550-2B FILM NUMBER: 04902614 MAIL ADDRESS: STREET 1: TWO BETHESDA METRO CENTER SUITE 1200 CITY: BETHESDA STATE: MD ZIP: 20814 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 4 1 edgardoc.xml PRIMARY DOCUMENT X0202 4 2004-07-01 0 0001040441 BEVERLY ENTERPRISES INC BEV 0001217563 SABEL IVAN R ONE THOUSAND BEVERLY WAY FORT SMITH AR 72919 1 0 0 0 PHANTOM STOCK UNITS 2004-07-01 4 A 0 644.8809 A 2004-07-01 $.10 Par Value Common Stock 644.8809 3058.1178 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, 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. By: MONA BRANNON For: IVAN R SABEL 2004-07-06 -----END PRIVACY-ENHANCED MESSAGE-----