0001127602-21-015416.txt : 20210505 0001127602-21-015416.hdr.sgml : 20210505 20210505131508 ACCESSION NUMBER: 0001127602-21-015416 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210503 FILED AS OF DATE: 20210505 DATE AS OF CHANGE: 20210505 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: 21892308 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 2021-05-03 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 and CEO Class B Common Stock 2021-05-03 4 J 0 45621 0 D 0 I MDM 2014 LLC as held by The Marc Daniel Miller 2019 GRAT Class B Common Stock 2021-05-03 4 J 0 45621 0 A 45621 I MDM 2014 LLC as held by Alan B. Miller Class B Common Stock 2021-05-03 4 J 0 24180 0 D 0 I MS 2014 LLC as held by The Marni Spencer 2019 GRAT Class B Common Stock 2021-05-03 4 J 0 24180 0 A 24180 I MS 2014 LLC as held by Alan B. Miller Class B Common Stock 2021-05-03 4 J 0 24180 0 D 0 I AMK 2014 LLC as held by The Abby Miller King 2019 GRAT Class B Common Stock 2021-05-03 4 J 0 24180 0 A 24180 I AMK 2014 LLC as held by Alan B. Miller Class B Common Stock 145901 D Class B Common Stock 16748 I AMK 2014 LLC held by The Abby Danielle Miller 2002 Trust Class B Common Stock 59072 I AMK 2014 LLC held by the Abby Miller King 2020 GRAT Class B Common Stock 130372 I MDM 2014 LLC as held by The Marc Daniel Miller 2020 GRAT Class B Common Stock 24007 I MDM 2014 LLC held by The Marc Daniel Miller 2002 Trust Class B Common Stock 59072 I MS 2014 LLC as held by The Marni Spencer 2020 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 2021-05-03 4 J 0 34216 0 D Class B Common Stock 34216 0 I MDM 2014 LLC as held by the Marc Daniel Miller 2019 GRAT Class A Common Stock 2021-05-03 4 J 0 34216 0 A Class B Common Stock 34216 34216 I MDM 2014 LLC as held by Alan B. Miller Class A Common Stock 2021-05-03 4 J 0 24180 0 D Class B Common Stock 24180 0 I MS 2014 LLC as held by The Marni Spencer 2019 GRAT Class A Common Stock 2021-05-03 4 J 0 24180 0 A Class B Common Stock 24180 24180 I MS 2014 LLC as held by Alan B. Miller Class A Common Stock 2021-05-03 4 J 0 24180 0 D Class B Common Stock 24180 0 I AMK 2014 LLC as held by the Abby Miller King 2019 GRAT Class A Common Stock 2021-05-03 4 J 0 24180 0 A Class B Common Stock 24180 24180 I AMK 2014 LLC as held by Alan B. Miller Class A Common Stock Class B Common Stock 532194 532194 I A. Miller Family, LLC Class A Common Stock Class B Common Stock 61500 61500 I Abby Danielle Miller Subtrust u/ Miller Family 2017 Trust 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 59072 59072 I AMK 2014 LLC held by the Abby Miller King 2020 GRAT 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 61500 61500 I Marc Daniel Miller Subtrust u/ Miller Family 2017 Trust Class A Common Stock Class B Common Stock 61500 61500 I Marni Spencer Subtrust u/ Miller Family 2017 Trust Class A Common Stock Class B Common Stock 97779 97779 I MDM 2014 LLC as held by The Marc Daniel Miller 2020 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 59072 59072 I MS 2014 LLC as held by The Marni Spencer 2020 GRAT Class A Common Stock Class B Common Stock 16748 16748 I MS 2014 LLC held by The Marni Spencer 2002 Trust Class A Common Stock Class B Common Stock 99063 99063 I The Abby Danielle Miller 2002 Trust Class A Common Stock Class B Common Stock 139195 139195 I The Marc Daniel Miller 2002 Trust Class A Common Stock Class B Common Stock 99063 99063 I The Marni Spencer 2002 Trust On May 03, 2021, The Marc Daniel Miller 2019 GRAT distributed 22.81049% of the MDM 2014 LLC to Alan B. Miller. Marc Miller disclaims any pecuniary interest in these shares. All distributions hereinbefore described were made pursuant to the terms of the Trust Agreement creating each 2019 GRAT. The MDM 2014 LLC holds 200,000 shares of Class B Common Stock and 150,000 shares of Class A Common Stock. On May 03, 2021, The Marni Spencer 2019 GRAT distributed 24.18044% of the MS 2014 LLC to Alan B. Miller. Marc Miller disclaims any pecuniary interest in these shares. All distributions hereinbefore described were made pursuant to the terms of the Trust Agreement creating each 2019 GRAT. The MS 2014 LLC holds 100,000 shares of Class B Common Stock and 100,000 shares of Class A Common Stock. On May 03, 2021, The Abby Miller King 2019 GRAT distributed 24.18044% of the AMK 2014 LLC to Alan B. Miller. Marc Miller disclaims any pecuniary interest in these shares. All distributions hereinbefore described were made pursuant to the terms of the Trust Agreement creating each 2019 GRAT. The AMK 2014 LLC holds 100,000 shares of Class B Common Stock and 100,000 shares of Class A Common Stock. The Class A Common Stock is convertible into Class B Common Stock on a share for share basis. Immediately. Not Applicable. /s/ Steve Filton, Attorney in Fact for Marc D. Miller 2021-05-05