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*
Miller Marc D

(Last) (First) (Middle)
UNIVERSAL HEALTH SERVICES, INC.
367 SOUTH GULPH ROAD

(Street)
KING OF PRUSSIA PA 19406

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
UNIVERSAL HEALTH SERVICES INC [ UHS ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
X Officer (give title below) Other (specify below)
President
3. Date of Earliest Transaction (Month/Day/Year)
03/05/2019
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
Class B Common Stock 03/05/2019 J(1) 31,319 D $0 0 I AMK 2014 LLC held by The Abby Miller King 2017 GRAT
Class B Common Stock 03/05/2019 J(1) 31,319 A $0 31,319 I AMK 2014 LLC as held by Alan B. Miller
Class B Common Stock 03/05/2019 J(1) 31,319 D $0 0 I MS 2014 LLC held by The Marni Spencer 2017 GRAT
Class B Common Stock 03/05/2019 J(1) 31,319 A $0 31,319 I MS 2014 LLC as held by Alan B. Miller
Class B Common Stock 03/05/2019 J(1) 44,896 D $0 0 I MDM 2014 LLC held by The Marc Daniel Miller 2017 GRAT
Class B Common Stock 03/05/2019 J(1) 44,896 A $0 44,896 I MDM 2014 LLC as held by Alan B. Miller
Class B Common Stock 135,237 D
Class B Common Stock 0 I AMK 2014 LLC
Class B Common Stock 16,748 I AMK 2014 LLC held by The Abby Danielle Miller 2002 Trust
Class B Common Stock 51,933 I AMK 2014 LLC held by the Abby Miller King 2018 GRAT
Class B Common Stock 131,097 I MDM 2014 LLC as held by The Marc Daniel Miller 2018 GRAT
Class B Common Stock 24,007 I MDM 2014 LLC held by The Marc Daniel Miller 2002 Trust
Class B Common Stock 51,933 I MS 2014 LLC as held by The Marni Spencer 2018 GRAT
Class B Common Stock 16,748 I MS 2014 LLC held by The Marni Spencer 2002 Trust
Class B Common Stock 22,815 I The Abby Danielle Miller 2002 Trust
Class B Common Stock 55,763 I The Abby Miller King 2011 Family Trust
Class B Common Stock 44,110 I The Marc Daniel Miller 2002 Trust
Class B Common Stock 59,900 I The Marc Daniel Miller 2011 Family Trust
Class B Common Stock 43,247 I The Marni Spencer 2002 Trust
Class B Common Stock 55,763 I The Marni Spencer 2011 Family Trust
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
Class A Common Stock (2) 03/05/2019 J(1) 31,319 (3) (4) Class B Common Stock 31,319 $0 0 I AMK 2014 LLC held by The Abby Miller King 2017 GRAT
Class A Common Stock (2) 03/05/2019 J(1) 31,319 (5) (6) Class B Common Stock 31,319 $0 31,319 I AMK 2014 LLC as held by Alan B. Miller
Class A Common Stock (2) 03/05/2019 J(1) 31,319 (3) (4) Class B Common Stock 31,319 $0 0 I MS 2014 LLC held by The Marni Spencer 2017 GRAT
Class A Common Stock (2) 03/05/2019 J(1) 31,319 (5) (6) Class B Common Stock 31,319 $0 31,319 I MS 2014 LLC as held by Alan B. Miller
Class A Common Stock (2) 03/05/2019 J(1) 33,671 (3) (4) Class B Common Stock 33,671 $0 0 I MDM 2014 LLC held by The Marc Daniel Miller 2017 GRAT
Class A Common Stock (2) 03/05/2019 J(1) 33,671 (5) (6) Class B Common Stock 33,671 $0 33,671 I MDM 2014 LLC as held by Alan B. Miller
Class A Common Stock (2) (3) (4) Class B Common Stock 160,563 160,563 I The Abby Danielle Miller 2002 Trust
Class A Common Stock (2) (3) (4) Class B Common Stock 200,695 200,695 I The Marc Daniel Miller 2002 Trust
Class A Common Stock (2) (3) (4) Class B Common Stock 160,563 160,563 I The Marni Spencer 2002 Trust
Class A Common Stock (2) (3) (4) Class B Common Stock 532,194 532,194 I A. Miller Family, LLC
Class A Common Stock (7) (3) (4) Class B Common Stock 51,933 51,933 I AMK 2014 LLC as held by The Abby Miller King 2018 GRAT
Class A Common Stock (2) (3) (4) Class B Common Stock 16,748 16,748 I AMK 2014 LLC held by The Abby Danielle Miller 2002 Trust
Class A Common Stock (7) (3) (4) Class B Common Stock 118,900 118,900 I By The Abby Miller King Family 2012 Trust
Class A Common Stock (7) (3) (4) Class B Common Stock 118,900 118,900 I By The Marc Daniel Miller Family 2012 Trust
Class A Common Stock (7) (3) (4) Class B Common Stock 118,900 118,900 I By The Marni Spencer Family 2012 Trust
Class A Common Stock (7) (3) (4) Class B Common Stock 98,324 98,324 I MDM 2014 LLC as held by the Marc Daniel Miller 2018 GRAT
Class A Common Stock (2) (3) (4) Class B Common Stock 18,005 18,005 I MDM 2014 LLC held by The Marc Daniel Miller 2002 Trust
Class A Common Stock (7) (3) (4) Class B Common Stock 51,933 51,933 I MS 2014 LLC as held by The Marni Spencer 2018 GRAT
Class A Common Stock (2) (3) (4) Class B Common Stock 16,748 16,748 I MS 2014 LLC held by The Marni Spencer 2002 Trust
Explanation of Responses:
1. 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.
2. These shares are convertible to Class B Common Stock on a share for share basis.
3. Immediately.
4. Not Applicable.
5. Immediately
6. Not Applicable
7. The Class A Common Stock is convertible into Class B Common Stock on a share for share basis.
/s/ Marc D. Miller 03/07/2019
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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