-----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, S75Uf2m7XW1CC1IZv4BNW1HhW0fEBFxP3qlahhucEQev0EPnzdWVrRzsFadDG/D9 DlNCV8LenqZ8tnTnn7OO2g== 0000915127-04-000014.txt : 20040112 0000915127-04-000014.hdr.sgml : 20040112 20040112102146 ACCESSION NUMBER: 0000915127-04-000014 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040109 FILED AS OF DATE: 20040112 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: PERLOW GERALD M MD CENTRAL INDEX KEY: 0001243430 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-22916 FILM NUMBER: 04519669 BUSINESS ADDRESS: STREET 1: PHC INC STREET 2: 200 LAKE ST STE 102 CITY: PEABODY STATE: MA ZIP: 01960 BUSINESS PHONE: 7815951607 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: PHC INC /MA/ CENTRAL INDEX KEY: 0000915127 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-HOME HEALTH CARE SERVICES [8082] IRS NUMBER: 042601571 STATE OF INCORPORATION: MA FISCAL YEAR END: 0630 BUSINESS ADDRESS: STREET 1: 200 LAKE ST STE 102 CITY: PEABODY STATE: MA ZIP: 01960 BUSINESS PHONE: 9785362777 MAIL ADDRESS: STREET 1: 200 LAKE ST STREET 2: STE 102 CITY: PEABODY STATE: MA ZIP: 01960 4 1 gp_form4ex.xml X0201 4 2004-01-09 0 0000915127 PHC INC /MA/ PIHC 0001243430 PERLOW GERALD M MD PHC INC 200 LAKE ST STE 102 PEABODY MA 01960 1 0 0 0 Class A Common Stock 2004-01-09 2004-01-09 4 D 0 0 0 D 46125 D Options 0 2004-01-09 2004-01-09 4 D 0 0 0 D 2004-01-09 2004-01-09 Options 0 77000 D Options Granted 1.33 2004-01-09 2004-01-09 4 A 0 10000 0 D 2004-01-09 2004-01-09 Options Granted 0 0 D Total Options 0 2004-01-09 2004-01-09 4 D 0 0 0 D 2004-01-09 2004-01-09 Total Options 0 87000 D No conversion price Used dummy dates as these shares are accumulative and have different dates Not applicable /s/ Gerald Perlow 2004-01-09 -----END PRIVACY-ENHANCED MESSAGE-----