0001127602-19-010358.txt : 20190307 0001127602-19-010358.hdr.sgml : 20190307 20190307110219 ACCESSION NUMBER: 0001127602-19-010358 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190305 FILED AS OF DATE: 20190307 DATE AS OF CHANGE: 20190307 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: 19664769 MAIL ADDRESS: STREET 1: 367 SOUTH GULPH ROAD CITY: KING OF PRUSSIA STATE: PA ZIP: 19406 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 4 1 form4.xml PRIMARY DOCUMENT X0306 4 2019-03-05 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 President Class B Common Stock 2019-03-05 4 J 0 31319 0 D 0 I AMK 2014 LLC held by The Abby Miller King 2017 GRAT Class B Common Stock 2019-03-05 4 J 0 31319 0 A 31319 I AMK 2014 LLC as held by Alan B. Miller Class B Common Stock 2019-03-05 4 J 0 31319 0 D 0 I MS 2014 LLC held by The Marni Spencer 2017 GRAT Class B Common Stock 2019-03-05 4 J 0 31319 0 A 31319 I MS 2014 LLC as held by Alan B. Miller Class B Common Stock 2019-03-05 4 J 0 44896 0 D 0 I MDM 2014 LLC held by The Marc Daniel Miller 2017 GRAT Class B Common Stock 2019-03-05 4 J 0 44896 0 A 44896 I MDM 2014 LLC as held by Alan B. Miller Class B Common Stock 135237 D Class B Common Stock 0 I AMK 2014 LLC Class B Common Stock 16748 I AMK 2014 LLC held by The Abby Danielle Miller 2002 Trust Class B Common Stock 51933 I AMK 2014 LLC held by the Abby Miller King 2018 GRAT Class B Common Stock 131097 I MDM 2014 LLC as held by The Marc Daniel Miller 2018 GRAT Class B Common Stock 24007 I MDM 2014 LLC held by The Marc Daniel Miller 2002 Trust Class B Common Stock 51933 I MS 2014 LLC as held by The Marni Spencer 2018 GRAT Class B Common Stock 16748 I MS 2014 LLC held by The Marni Spencer 2002 Trust Class B Common Stock 22815 I The Abby Danielle Miller 2002 Trust Class B Common Stock 55763 I The Abby Miller King 2011 Family Trust Class B Common Stock 44110 I The Marc Daniel Miller 2002 Trust Class B Common Stock 59900 I The Marc Daniel Miller 2011 Family Trust Class B Common Stock 43247 I The Marni Spencer 2002 Trust Class B Common Stock 55763 I The Marni Spencer 2011 Family Trust Class A Common Stock 2019-03-05 4 J 0 31319 0 D Class B Common Stock 31319 0 I AMK 2014 LLC held by The Abby Miller King 2017 GRAT Class A Common Stock 2019-03-05 4 J 0 31319 0 A Class B Common Stock 31319 31319 I AMK 2014 LLC as held by Alan B. Miller Class A Common Stock 2019-03-05 4 J 0 31319 0 D Class B Common Stock 31319 0 I MS 2014 LLC held by The Marni Spencer 2017 GRAT Class A Common Stock 2019-03-05 4 J 0 31319 0 A Class B Common Stock 31319 31319 I MS 2014 LLC as held by Alan B. Miller Class A Common Stock 2019-03-05 4 J 0 33671 0 D Class B Common Stock 33671 0 I MDM 2014 LLC held by The Marc Daniel Miller 2017 GRAT Class A Common Stock 2019-03-05 4 J 0 33671 0 A Class B Common Stock 33671 33671 I MDM 2014 LLC as held by Alan B. Miller 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 Class A Common Stock Class B Common Stock 532194 532194 I A. Miller Family, LLC Class A Common Stock Class B Common Stock 51933 51933 I AMK 2014 LLC as held by The Abby Miller King 2018 GRAT Class A Common Stock Class B Common Stock 16748 16748 I AMK 2014 LLC held by The Abby Danielle Miller 2002 Trust Class A Common Stock Class B Common Stock 118900 118900 I By The Abby Miller King Family 2012 Trust Class A Common Stock Class B Common Stock 118900 118900 I By The Marc Daniel Miller Family 2012 Trust Class A Common Stock Class B Common Stock 118900 118900 I By The Marni Spencer Family 2012 Trust Class A Common Stock Class B Common Stock 98324 98324 I MDM 2014 LLC as held by the Marc Daniel Miller 2018 GRAT Class A Common Stock Class B Common Stock 18005 18005 I MDM 2014 LLC held by The Marc Daniel Miller 2002 Trust Class A Common Stock Class B Common Stock 51933 51933 I MS 2014 LLC as held by The Marni Spencer 2018 GRAT Class A Common Stock Class B Common Stock 16748 16748 I MS 2014 LLC held by The Marni Spencer 2002 Trust On March 5, 2019, The Marc Daniel Miller 2017 GRAT distributed a 22.44772% interest in MDM 2014 LLC to Alan B. Miller, The Abby Miller King 2017 GRAT distributed a 31.32029% interest in AMK 2014 LLC to Alan B. Miller, and The Marni Spencer 2017 GRAT distributed a 31.32029% interest in AMK 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. All distributions hereinbefore described were made pursuant to the terms of the Trust Agreement creating each 2017 GRAT. Each 2017 GRAT is now terminated. These shares are convertible to Class B Common Stock on a share for share basis. Immediately. Not Applicable. Immediately Not Applicable The Class A Common Stock is convertible into Class B Common Stock on a share for share basis. /s/ Marc D. Miller 2019-03-07