-----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, M1gqgQnvgsQ5BE9SvuHDEmcRFCLtxqpH7A2XFRZfso6YgJc71aTErpHjiGXkmdLJ TkVgK0VknTQYl2zMVFi6hA== 0001209191-05-007029.txt : 20050204 0001209191-05-007029.hdr.sgml : 20050204 20050204170554 ACCESSION NUMBER: 0001209191-05-007029 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20041231 FILED AS OF DATE: 20050204 DATE AS OF CHANGE: 20050204 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MCDONALD KEN P CENTRAL INDEX KEY: 0001200151 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-22217 FILM NUMBER: 05577925 BUSINESS ADDRESS: STREET 1: AMSURG CORP STREET 2: 20 BURTON HILLS BLVD. CITY: NASHVILLE STATE: TN ZIP: 37215 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: AMSURG CORP CENTRAL INDEX KEY: 0000895930 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-OFFICES & CLINICS OF DOCTORS OF MEDICINE [8011] IRS NUMBER: 621493316 STATE OF INCORPORATION: TN FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 20 BURTON HILLS BLVD STREET 2: STE 350 CITY: NASHVILLE STATE: TN ZIP: 37215 BUSINESS PHONE: 6156651283 MAIL ADDRESS: STREET 1: ONE BURTON HILLS BLVD. STREET 2: SUITE 350 CITY: NASHVILLE STATE: TN ZIP: 37215 5 1 doc5.xml FORM 5 SUBMISSION X0202 5 2004-12-31 0 0 0 0000895930 AMSURG CORP AMSG 0001200151 MCDONALD KEN P 20 BURTON HILLS BOULEVARD NASHVILLE TN 37215 1 1 0 0 President and CEO Common stock 3 I By spouse Employee stock option 4.50 2000-01-27 2010-01-27 Common stock 90000 90000 D Employee stock option 16.583 2001-02-01 2011-02-01 Common stock 150000 150000 D Employee stock option 14.667 2001-11-15 2011-11-15 Common stock 150000 150000 D Employee stock option 16.20 2002-01-24 2012-01-24 Common stock 105000 105000 D Employee stock option 14.78 2003-02-06 2013-02-06 Common stock 276000 276000 D Employee stock option 24.10 2004-01-28 2014-01-28 Common stock 255000 255000 D Options are to purchase shares of common stock and vest in equal installments over 4 years, starting on the Date Exercisable. /s/ Ken P. McDonald 2005-02-04 -----END PRIVACY-ENHANCED MESSAGE-----