-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, DjDORst4Eng3jM1xL7MEQKNi0CoSf0OWsoUpLWOPuaiW+Gt72uhV52sr/SwySDeX KOztUZjQGx4DyUwLZdcHLg== 0000950116-04-003965.txt : 20041229 0000950116-04-003965.hdr.sgml : 20041229 20041229123918 ACCESSION NUMBER: 0000950116-04-003965 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20041227 FILED AS OF DATE: 20041229 DATE AS OF CHANGE: 20041229 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: CARPENTER THOMAS B CENTRAL INDEX KEY: 0001210675 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-12015 FILM NUMBER: 041230163 MAIL ADDRESS: STREET 1: 3220 TILLMAN DR STREET 2: SUITE 300 CITY: BENSALEM STATE: PA ZIP: 19020 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: HEALTHCARE SERVICES GROUP INC CENTRAL INDEX KEY: 0000731012 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-TO DWELLINGS & OTHER BUILDINGS [7340] IRS NUMBER: 232018365 STATE OF INCORPORATION: PA FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 2643 HUNTINGDON PIKE CITY: HUNTINGDON VALLEY STATE: PA ZIP: 19006 BUSINESS PHONE: 2159381661 MAIL ADDRESS: STREET 1: 2643 HUNTINGDON PIKEE CITY: HUNTINGDON VALLEY STATE: PA ZIP: 19006 4 1 p403213_ex.xml FORM 4 X0202 4 2004-12-27 0 0000731012 HEALTHCARE SERVICES GROUP INC HCSG 0001210675 CARPENTER THOMAS B 3220 TILLMAN DRIVE SUITE 300 BENSALEM PA 19020 0 1 0 1 ASSISTANT SECRETARY GENERAL COUNSEL COMMON STOCK 872 D STOCK OPTION 20.48 2004-12-27 4 A 0 5000 20.48 A 2005-06-27 2014-12-27 COMMON STOCK 5000 13072 D /S/ THOMAS B. CARPENTER 2004-12-29 -----END PRIVACY-ENHANCED MESSAGE-----