0000899243-17-005027.txt : 20170222 0000899243-17-005027.hdr.sgml : 20170222 20170222213306 ACCESSION NUMBER: 0000899243-17-005027 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170217 FILED AS OF DATE: 20170222 DATE AS OF CHANGE: 20170222 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: UNIVERSAL HEALTH SERVICES INC CENTRAL INDEX KEY: 0000352915 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-GENERAL MEDICAL & SURGICAL HOSPITALS, NEC [8062] IRS NUMBER: 232077891 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 367 S GULPH RD CITY: KING OF PRUSSIA STATE: PA ZIP: 19406 BUSINESS PHONE: 6107683300 MAIL ADDRESS: STREET 1: 367 S GULPH ROAD CITY: KING OF PRUSSIA STATE: PA ZIP: 19406 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Miller Marc D CENTRAL INDEX KEY: 0001315495 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-10765 FILM NUMBER: 17630580 MAIL ADDRESS: STREET 1: 367 SOUTH GULPH ROAD CITY: KING OF PRUSSIA STATE: PA ZIP: 19406 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2017-02-17 0 0000352915 UNIVERSAL HEALTH SERVICES INC UHS 0001315495 Miller Marc D UNIVERSAL HEALTH SERVICES, INC. 367 SOUTH GULPH ROAD KING OF PRUSSIA PA 19406 1 1 0 0 President Class B Common Stock 2017-02-17 4 J 0 60042 0.00 D 0 I AMK 2014 LLC held by The Abby Miller King 2014 GRAT Class B Common Stock 2017-02-17 4 J 0 60042 0.00 D 0 I MDM 2014 LLC held by The Marc Daniel Miller 2014 GRAT Class B Common Stock 2017-02-17 4 J 0 60042 0.00 D 0 I MS 2014 LLC held by The Marni Spencer 2014 GRAT Class B Common Stock 2017-02-17 4 J 0 14858 0.00 A 14858 I AMK 2014 LLC held by The Abby Danielle Miller 2002 Trust Class B Common Stock 2017-02-17 4 J 0 14858 0.00 A 14858 I MDM 2014 LLC held by The Marc Daniel Miller 2002 Trust Class B Common Stock 2017-02-17 4 J 0 14858 0.00 A 14858 I MS 2014 LLC held by The Marni Spencer 2002 Trust Class B Common Stock 2017-02-17 4 J 0 17699 0.00 D 22259 I AMK 2014 LLC held by The Abby Miller King 2015 GRAT Class B Common Stock 2017-02-17 4 J 0 17699 0.00 D 22259 I MDM 2014 LLC held by The Marc Daniel Miller 2015 GRAT Class B Common Stock 2017-02-17 4 J 0 17699 0.00 D 22259 I MS 2014 LLC held by The Marni Spencer 2015 GRAT Class B Common Stock 2017-02-17 4 J 0 62883 0.00 A 62883 I AMK 2014 LLC held by The Abby Miller King 2017 GRAT Class B Common Stock 2017-02-17 4 J 0 62883 0.00 A 62883 I MDM 2014 LLC held by The Marc Daniel Miller 2017 GRAT Class B Common Stock 2017-02-17 4 J 0 62883 0.00 A 62883 I MS 2014 LLC held by The Marni Spencer 2017 GRAT Class B Common Stock 87345 D Class B Common Stock 55763 I The Abby Miller King 2011 Family Trust Class B Common Stock 59900 I The Marc Daniel Miller 2011 Family Trust Class B Common Stock 55763 I The Marni Spencer 2011 Family Trust Class B Common Stock 43247 I The Abby Danielle Miller 2002 Trust Class B Common Stock 44110 I The Marc Daniel Miller 2002 Trust Class B Common Stock 43247 I The Marni Spencer 2002 Trust Class A Common Stock 2017-02-17 4 J 0 60042 0.00 D Class B Common Stock 60042 0 I AMK 2014 LLC held by The Abby Miller King 2014 GRAT Class A Common Stock 2017-02-17 4 J 0 90063 0.00 D Class B Common Stock 90063 0 I MDM 2014 LLC held by The Marc Daniel Miller 2014 GRAT Class A Common Stock 2017-02-17 4 J 0 60042 0.00 D Class B Common Stock 60042 0 I MS 2014 LLC held by The Marni Spencer 2014 GRAT Class A Common Stock 2017-02-17 4 J 0 14858 0.00 A Class B Common Stock 14858 14858 I AMK 2014 LLC held by The Abby Danielle Miller 2002 Trust Class A Common Stock 2017-02-17 4 J 0 22287 0.00 A Class B Common Stock 22287 22287 I MDM 2014 LLC held by The Marc Daniel Miller 2002 Trust Class A Common Stock 2017-02-17 4 J 0 14858 0.00 A Class B Common Stock 14858 14858 I MS 2014 LLC held by The Marni Spencer 2002 Trust Class A Common Stock 2017-02-17 4 J 0 17699 0.00 D Class B Common Stock 17699 22259 I AMK 2014 LLC held by The Abby Miller King 2015 GRAT Class A Common Stock 2017-02-17 4 J 0 26549 0.00 D Class B Common Stock 26549 33388 I MDM 2014 LLC held by The Marc Daniel Miller 2015 GRAT Class A Common Stock 2017-02-17 4 J 0 17699 0.00 D Class B Common Stock 17699 22259 I MS 2014 LLC held by The Marni Spencer 2015 GRAT Class A Common Stock 2017-02-17 4 J 0 62883 0.00 A Class B Common Stock 62883 62883 I AMK 2014 LLC held by The Abby Miller King 2017 GRAT Class A Common Stock 2017-02-17 4 J 0 94325 0.00 A Class B Common Stock 94325 94325 I MDM 2014 LLC held by The Marc Daniel Miller 2017 GRAT Class A Common Stock 2017-02-17 4 J 0 62883 0.00 A Class B Common Stock 62883 62883 I MS 2014 LLC held by The Marni Spencer 2017 GRAT Class A Common Stock Class B Common Stock 532194 532194 I A. Miller Family, LLC Class A Common Stock Class B Common Stock 118900 118900 I The Abby Miller King Family 2012 Trust Class A Common Stock Class B Common Stock 118900 118900 I The Marni Spencer Family 2012 Trust Class A Common Stock Class B Common Stock 160563 160563 I The Abby Danielle Miller 2002 Trust Class A Common Stock Class B Common Stock 200695 200695 I The Marc Daniel Miller 2002 Trust Class A Common Stock Class B Common Stock 160563 160563 I The Marni Spencer 2002 Trust The Class A Common Stock is convertible into Class B Common Stock on a share for share basis. On February 17, 2017, The Marc Daniel Miller 2014 GRAT distributed a 45.18379% interest in MDM 2014 LLC to Alan B. Miller, The Abby Miller King 2014 GRAT distributed a 45.18437% interest in AMK 2014 LLC to Alan B. Miller and The Marni Spencer 2014 GRAT distributed a 45.18437% interest of MS 2014 LLC to Alan B. Miller. In addition, The Marc Daniel Miller 2014 GRAT distributed a 14.85844% interest in MDM 2014 LLC to The Marc Daniel Miller 2002 Trust, The Abby Miller King 2014 GRAT distributed a 14.85759% interest in AMK 2014 LLC to The Abby Danielle Miller 2002 Trust and The Marni Spencer 2014 GRAT distributed a 14.85759% interest in MS 2014 LLC to The Marni Spencer 2002 Trust. (Continued from Footnote 2) All of the distributions hereinbefore described were made pursuant to the terms of the Trust Agreement creating each 2014 GRAT. Each 2014 GRAT has now terminated. The shares reflected represent the amount of shares held by each LLC as represented by the percentage LLC interests distributed. The reporting person is a trustee of each GRAT and each 2002 Trust and is a special manager of each LLC but disclaims beneficial interest in each GRAT and each 2002 Trust other than The Marc Daniel Miller 2014 GRAT and The Marc Daniel Miller 2002 Trust, and each LLC other than MDM 2014 LLC. On February 17, 2017, The Marc Daniel Miller 2015 GRAT distributed a 17.69925% interest in MDM 2014 LLC to Alan B. Miller, The Abby Miller King 2015 GRAT distributed a 17.69948% interest in AMK 2014 LLC to Alan B. Miller and The Marni Spencer 2015 GRAT distributed a 17.69948% interest in MS 2014 LLC to Alan B. Miller (the distributions were made pursuant to the terms of the Trust Agreement creating each 2015 GRAT). The shares reflected represent the amount of shares held by each LLC as represented by the percentage LLC interests distributed. The reporting person is a trustee of each GRAT and a special manager of each LLC but disclaims beneficial interest in each GRAT and each other than the Marc Daniel Miller 2015 GRAT and each LLC other than MDM 2014 LLC. On February 17, 2017, Alan B. Miller contributed a 62.88303% interest in MDM 2014 LLC to The Marc Daniel Miller 2017 GRAT, a 62.88385% interest in AMK 2014 LLC to The Abby Miller King 2017 GRAT and a 62.88385% interest in MS 2014 LLC to The Marni Spencer 2017 GRAT. The shares reflected represent the amount of shares held by each LLC as represented by the percentage LLC interests contributed. The reporting person is a trustee of each GRAT and a special manager of each LLC but disclaims beneficial interest in each GRAT other than the Marc Daniel Miller 2017 GRAT and each LLC other than the MDM 2014 LLC. The reporting person is a trustee of each of the 2011 Family Trusts for the benefit of Alan B. Miller's three children and has sole voting power with respect to these shares. The reporting person disclaims beneficial ownership of the shares of Class A Common Stock held by The Abby Miller King 2011 Family Trust and The Marni Spencer 2011 Family Trust. Immediately Not Applicable The reporting person is the sole manager of the A. Miller Family, LLC and during his tenure as such, has voting and dispositive power with respect to the Class A Common Stock held by the A. Miller Family, LLC. The reporting person disclaims beneficial ownership of the shares of Class A Common Stock held by the A. Miller Family, LLC except to the extent of his pecuniary interest therein. The reporting person is a trustee of each of The Abby Miller King Family 2012 Trust and The Marni Spencer Family 2012 Trust and has sole voting power with respect to these shares. The reporting person disclaims beneficial ownership of the shares of Class A Common Stock held by The Abby Miller King Family 2012 Trust and The Marni Spencer Family 2012 Trust. The reporting person is a trustee of each of The Abby Danielle Miller 2002 Trust, The Marc Daniel Miller 2002 Trust and The Marni Spencer 2002 Trust but disclaims beneficial ownership of the shares of Class A Common Stock held by The Abby Danielle Miller 2002 Trust and The Marni Spencer 2002 Trust. /s/ Marc D. Miller 2017-02-22