-----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, SANayb6ffQzVVIjxO5j91Cy6xf8rUomaCMqPOsbZdGbTR4gn9ndSXBNhBZZAk9Fu nhcC+9Bu8v81Lf3cAagJ/w== 0001040441-04-000174.txt : 20040820 0001040441-04-000174.hdr.sgml : 20040820 20040820132007 ACCESSION NUMBER: 0001040441-04-000174 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040818 FILED AS OF DATE: 20040820 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: KOLLING PATRICIA C CENTRAL INDEX KEY: 0001201496 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-09550-2B FILM NUMBER: 04988339 BUSINESS ADDRESS: STREET 1: ONE THOUSAND BEVERLY WAY CITY: FORT SMITH STATE: AR ZIP: 72919 BUSINESS PHONE: 4792012000 MAIL ADDRESS: STREET 1: C/O BEVERLY ENTERPRISES INC STREET 2: ONE THOUSAND BEVERLY WAY CITY: FORT SMITH STATE: AR ZIP: 72919 4 1 edgardoc.xml PRIMARY DOCUMENT X0202 4 2004-08-18 0 0001040441 BEVERLY ENTERPRISES INC BEV 0001201496 KOLLING PATRICIA C ONE THOUSAND BEVERLY WAY FORT SMITH AR 72919 0 1 0 0 SENIOR VICE PRESIDENT- $.10 Par Value Common Stock 2004-08-18 4 F 0 6718 7.45 D 56066 D Shares traded in payment of taxes associated with scheduled vesting of restricted shares. By: MONA BRANNON For: PATRICIA C KOLLING 2004-08-20 -----END PRIVACY-ENHANCED MESSAGE-----