0000899243-17-005029.txt : 20170222 0000899243-17-005029.hdr.sgml : 20170222 20170222214653 ACCESSION NUMBER: 0000899243-17-005029 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 ALAN B CENTRAL INDEX KEY: 0001181031 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-10765 FILM NUMBER: 17630603 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 0001181031 MILLER ALAN B UNIVERSAL HEALTH SERVICES, INC. 367 SOUTH GULPH ROAD KING OF PRUSSIA PA 19406 1 1 1 0 Chairman and CEO 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 45184 0.00 A 967061 D 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 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 45184 0.00 A 1012245 D 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 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 45184 0.00 A 1057429 D 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 A 1075128 D 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 A 1092827 D 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 17699 0.00 A 1110526 D Class B Common Stock 2017-02-17 4 J 0 62883 0.00 D 1047643 D 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 D 984760 D 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 D 921877 D 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 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 45184 0.00 A Class B Common Stock 45184 4200439 D 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 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 67776 0.00 A Class B Common Stock 67776 4268215 D 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 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 45184 0.00 A Class B Common Stock 45184 4313399 D 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 17699 0.00 A Class B Common Stock 17699 4331098 D 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 26549 0.00 A Class B Common Stock 26549 4357647 D 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 17699 0.00 A Class B Common Stock 17699 4375346 D Class A Common Stock 2017-02-17 4 J 0 62883 0.00 D Class B Common Stock 62883 4312463 D 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 D Class B Common Stock 94325 4218138 D 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 D Class B Common Stock 62883 4155255 D 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 400000 400000 I Alan B. Miller Marital Trust (f/b/o Jill Miller) Class A Common Stock Class B Common Stock 258630 258630 I The Alan B. Miller 2002 Trust 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 The shares reflected represent the amount of shares held by each LLC as represented by the percentage LLC interests distributed. Mr. Miller's pecuniary interest in these shares is unchanged. 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 1) All distributions hereinbefore described were made pursuant to the terms of the Trust Agreement creating each 2014 GRAT. Each 2014 GRAT has now terminated. 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. Mr. Miller's pecuniary interest in these shares is unchanged. 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. Mr. Miller's pecuniary interest in these shares is unchanged. The Class A Common Stock is convertible into Class B Common Stock on a share for share basis. Immediately Not Applicable /s/ Alan B. Miller 2017-02-22