SC 13G/A 1 g67087a2sc13ga.txt AMSURG CORP. 1 SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 ----------------------------- Schedule 13G/A (Rule 13d-102) INFORMATION TO BE INCLUDED IN STATEMENTS FILED PURSUANT TO RULES 13d-1(b), (c), AND (d) AND AMENDMENTS THERETO FILED PURSUANT TO 13d-2(b) (Amendment No. 2) AmSurg Corp. ------------------------------------------------------------------------------- (Name of Issuer) Class B Common Stock, no par value ------------------------------------------------------------------------------- (Title of Class of Securities) 3232P 20 7 -------------------------------------------------------------------------------- (CUSIP Number) December 31, 2000 -------------------------------------------------------------------------------- (Date of Event Which Requires Filing of this Statement) Check the appropriate box to designate the rule pursuant to which this Schedule is filed: [ ] Rule 13d-1(b) [X] Rule 13d-1(c) [ ] Rule 13d-1(d) Page 1 of 5 Pages 2 ------------------------------ ----------------------- CUSIP NO. 3232P 20 7 13G/A Page 2 of 5 Pages ------------------------------ ----------------------- ------------------------------------------------------------------------------------------- 1 NAME OF REPORTING PERSON I.R.S. IDENTIFICATION NO. OF ABOVE PERSON (ENTITIES ONLY) Thomas G. Cigarran ------------------------------------------------------------------------------------------- 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a) [ ] (b) [ ] ------------------------------------------------------------------------------------------- 3 SEC USE ONLY ------------------------------------------------------------------------------------------- 4 CITIZENSHIP OR PLACE OF ORGANIZATION United States ------------------------------------------------------------------------------------------- NUMBER OF 5 SOLE VOTING POWER SHARES 378,554 BENEFICIALLY -------------------------------------------------------------- OWNED BY 6 SHARED VOTING POWER EACH 0 REPORTING -------------------------------------------------------------- PERSON 7 SOLE DISPOSITIVE POWER WITH 378,554 -------------------------------------------------------------- 8 SHARED DISPOSITIVE POWER 0 ------------------------------------------------------------------------------------------- 9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 378,554 ------------------------------------------------------------------------------------------- 10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES* (a) [ ] ------------------------------------------------------------------------------------------- 11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 7.9% ------------------------------------------------------------------------------------------- 12 TYPE OF REPORTING PERSON* IN ------------------------------------------------------------------------------------------- *SEE INSTRUCTION BEFORE FILLING OUT!
3 ------------------------------ ----------------------- CUSIP NO. 3232P 20 7 13G/A Page 3 of 5 Pages ------------------------------ ----------------------- Item 1(a). Name of Issuer: AmSurg Corp. Item 1(b). Address of Issuer's 20 Burton Hills Boulevard Principal Executive Nashville, Tennessee 37215 Offices: Item 2(a). Name of Person Filing: Thomas G. Cigarran Item 2(b). Address of Principal 20 Burton Hills Boulevard Business Office: Nashville, Tennessee 37215 Item 2(c). Organization/Citizenship: United States citizen Item 2(d). Title of Class Class B Common stock, no par value Of Securities: Item 2(e). CUSIP Number: 3232P 20 7 Item 3. Inapplicable. Item 4. Ownership.
TOTAL SHARES OF CLASS B COMMON SOLE SHARED STOCK PERCENT SOLE SHARED POWER POWER BENEFICIALLY OF VOTING VOTING TO TO PERSON OWNED CLASS(1) POWER POWER DISPOSE DISPOSE ------------------ ------------ -------- ------ ------ ------- ------- Thomas G. Cigarran 378,554 7.9% 378,554 -- 378,554 --
-------------------------- (1) Based on 4,787,131 shares of Class B Common Stock outstanding as of December 31, 2000. 4 ------------------------------ ----------------------- CUSIP NO. 3232P 20 7 13G/A Page 4 of 5 Pages ------------------------------ ----------------------- Item 5. Ownership of Five Percent or Less of a Class. Inapplicable. Item 6. Ownership of More than Five Percent on Behalf of Another Person. Inapplicable. Item 7. Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on by the Parent Holding Company. Inapplicable. Item 8. Identification and Classification of Members of the Group. Inapplicable. Item 9. Notice of Dissolution of Group. Inapplicable. Item 10. Certification. Inapplicable. 5 ------------------------------ ----------------------- CUSIP NO. 3232P 20 7 13G/A Page 5 of 5 Pages ------------------------------ ----------------------- SIGNATURE After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct. February 14, 2001 --------------------------------------------------------- Date /s/ Thomas G. Cigarran --------------------------------------------------------- (Signature) Thomas G. Cigarran, Chairman of the Board of AmSurg Corp. --------------------------------------------------------- (Name/Title)