0001127602-16-059043.txt : 20160801 0001127602-16-059043.hdr.sgml : 20160801 20160801154850 ACCESSION NUMBER: 0001127602-16-059043 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160801 FILED AS OF DATE: 20160801 DATE AS OF CHANGE: 20160801 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: UNIVERSAL HEALTH REALTY INCOME TRUST CENTRAL INDEX KEY: 0000798783 STANDARD INDUSTRIAL CLASSIFICATION: REAL ESTATE INVESTMENT TRUSTS [6798] IRS NUMBER: 236858580 STATE OF INCORPORATION: MD FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: UNIVERSAL CORPORATE CTR STREET 2: 367 S GULPH RD CITY: KING OF PRUSSIA STATE: PA ZIP: 19406 BUSINESS PHONE: 610-265-0688 MAIL ADDRESS: STREET 1: UNIVERSAL CORPORATE CTR STREET 2: 367 S GULPH ROAD CITY: KING OF PRUSSIA STATE: PA ZIP: 19406 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: FOWLER TIMOTHY J CENTRAL INDEX KEY: 0001180998 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-09321 FILM NUMBER: 161797212 4 1 form4.xml PRIMARY DOCUMENT X0306 4 2016-08-01 0000798783 UNIVERSAL HEALTH REALTY INCOME TRUST UHT 0001180998 FOWLER TIMOTHY J UNIVERSAL HEALTH REALTY INCOME TRUST 3525 PIEDMONT ROAD, N.E. ATLANTA GA 30305 1 Vice President Shares Of Beneficial Interest 2016-08-01 4 M 0 3000 59.67 A 20195 D Shares Of Beneficial Interest 2016-08-01 4 F 0 1837 59.67 D 18358 D Option To Purchase Shares Of Beneficial Interest 36.53 2016-08-01 4 M 0 3000 0 D 2017-03-01 Shares Of Beneficial Interest 3000 0 D The option vested ratably on each of 3/1/2008, 3/1/2009, 3/1/2010 and 3/1/2011. The reporting person has also been granted Dividend Equivalent Rights on the same terms as the options, pursuant to which the reporting person will receive the accrued cash dividends upon exercise of the Dividend Equivalent Rights. /s/ Timothy J. Fowler 2016-08-01