SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
DEPARLE NANCY ANN

(Last) (First) (Middle)
5800 TENNYSON PARKWAY

(Street)
PLANO TX 75024

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
TRIAD HOSPITALS INC [ TRI ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
07/25/2007
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 07/25/2007 D 6,466 D $54 0 D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Stock Option (right to buy) $24.98 07/25/2007 D 20,000 (1) 05/29/2011 Common Stock 20,000 $29.02 0 D
Stock Option (right to buy) $40.84 07/25/2007 D 7,500 (2) 05/21/2012 Common Stock 7,500 $13.16 0 D
Stock Option (right to buy) $24.45 07/25/2007 D 7,500 (3) 05/20/2013 Common Stock 7,500 $29.55 0 D
Stock Option (right to buy) $34.19 07/25/2007 D 8,000 (4) 05/25/2014 Common Stock 8,000 $19.81 0 D
Explanation of Responses:
1. This option, which provided for vesting in four equal annual installments beginning May 29, 2002, was canceled pursuant to the merger agreement between the Issuer, Community Health Systems, Inc. and FWCT-1 Corporation in exchange for a cash payment of $580,400, representing the difference between the exercise price of the option and the cash merger consideration ($54 per share).
2. This option, which provided for vesting in four equal annual installments beginning May 21, 2003, was canceled in the merger in exchange for a cash payment of $98,700, representing the difference between the exercise price of the option and the cash merger consideration ($54 per share).
3. This option, which provided for vesting in four equal annual installments beginning May 20, 2004, was canceled in the merger in exchange for a cash payment of $221,625, representing the difference between the exercise price of the option and the cash merger consideration ($54 per share).
4. This option, which provided for vesting in four equal annual installments beginning May 25, 2005, was canceled in the merger in exchange for a cash payment of $158,480, representing the difference between the exercise price of the option and the cash merger consideration ($54 per share).
Remarks:
Rebecca Hurley, as attorney-in-fact for Nancy-Ann DeParle 07/25/2007
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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