-----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, EJ1BbiThL1cN+4eWcM4nNAOjAnPrKK4B6ECFVrWh7tri9RK1f0f4KfPdGxo/gh/I A+yXYnrJNErWuNhtQEMIhQ== 0001040441-05-000014.txt : 20050114 0001040441-05-000014.hdr.sgml : 20050114 20050114110616 ACCESSION NUMBER: 0001040441-05-000014 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20050111 FILED AS OF DATE: 20050114 DATE AS OF CHANGE: 20050114 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: WASHBURN JANE A CENTRAL INDEX KEY: 0001314290 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-09550-2B FILM NUMBER: 05529534 BUSINESS ADDRESS: BUSINESS PHONE: 479-201-2000 MAIL ADDRESS: STREET 1: ONE THOUSAND BEVERLY WAY CITY: FORT SMITH STATE: AR ZIP: 72919 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 3 1 edgardoc.xml PRIMARY DOCUMENT X0202 3 2005-01-11 1 0001040441 BEVERLY ENTERPRISES INC BEV 0001314290 WASHBURN JANE A ONE THOUSAND BEVERLY WAY FORT SMITH AR 72919 0 1 0 0 SENIOR VICE PRESIDENT By: Mona Brannon, by Power of Attorney For: Jane A. Washburn 2005-01-14 -----END PRIVACY-ENHANCED MESSAGE-----