-----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, CRKuwEry55ZHJ9Dxnx6zJvEie6XIUTuiMGqaGcUMAlwDKTMuz/q1UmaOAkD0o3Da +i4jvo7ehjRU0FGKcdBxnA== 0001125282-05-006875.txt : 20051230 0001125282-05-006875.hdr.sgml : 20051230 20051230175822 ACCESSION NUMBER: 0001125282-05-006875 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20051230 FILED AS OF DATE: 20051230 DATE AS OF CHANGE: 20051230 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: COOK THOMAS A CENTRAL INDEX KEY: 0001213195 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-12015 FILM NUMBER: 051295376 MAIL ADDRESS: STREET 1: 3220 TILLMAN DRIVE SUIE 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 form.xml X0202 4 2005-12-30 0000731012 HEALTHCARE SERVICES GROUP INC HCSG 0001213195 COOK THOMAS A 3220 TILLMAN DRIVE SUIE 300 BENSALEM PA 19020 1 1 President/COO Common stock 15594 D Stock option 20.71 2005-12-30 4 A 0 25000 20.71 A 2005-12-30 2010-12-30 Common stock 25000 554160 D /s/ Thomas Cook 2005-12-30 -----END PRIVACY-ENHANCED MESSAGE-----