FORM 4 | UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
OMB APPROVAL |
OMB Number: | 3235-0287 |
Estimated average burden |
hours per response: | 0.5 |
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| Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue.
See
Instruction 1(b). |
1. Name and Address of Reporting Person*
UNIVERSAL HEALTH SERVICES, INC. |
367 SOUTH GULPH ROAD |
(Street)
| 2. Issuer Name and Ticker or Trading Symbol
UNIVERSAL HEALTH SERVICES INC
[ UHS ]
| 5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X | Director |
| 10% Owner |
X | Officer (give title below) |
| Other (specify below) |
President |
|
3. Date of Earliest Transaction
(Month/Day/Year) 8/7/20 |
4. If Amendment, Date of Original Filed
(Month/Day/Year)
| 6. Individual or Joint/Group Filing (Check Applicable Line)
X | Form filed by One Reporting Person |
| Form filed by More than One Reporting Person |
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned |
1. Title of Security (Instr.
3)
| 2. Transaction Date
(Month/Day/Year) | 2A. Deemed Execution Date, if any
(Month/Day/Year) | 3. Transaction Code (Instr.
8)
| 4. Securities Acquired (A) or Disposed Of (D) (Instr.
3, 4 and 5)
| 5.
Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr.
3 and 4)
| 6. Ownership Form: Direct (D) or Indirect (I) (Instr.
4)
| 7. Nature of Indirect Beneficial Ownership (Instr.
4)
|
Code | V | Amount | (A) or (D) | Price |
Class B Common Stock | 8/7/20 |
| J |
| 29,569 | D | $0 | 0 | I | AMK 2014 LLC held by the Abby Miller King 2018 GRAT |
Class B Common Stock | 8/7/20 |
| J |
| 29,569 | A | $0 | 29,569 | I | AMK 2014 LLC as held by Alan B. Miller |
Class B Common Stock | 8/7/20 |
| J |
| 29,503 | D | $0 | 24,180 | I | AMK 2014 LLC as held by The Abby Miller King 2019 GRAT |
Class B Common Stock | 8/7/20 |
| J |
| 29,503 | A | $0 | 59,072 | I | AMK 2014 LLC as held by Alan B. Miller |
Class B Common Stock | 8/7/20 |
| J |
| 59,072 | D | $0 | 0 | I | AMK 2014 LLC as held by Alan B. Miller |
Class B Common Stock | 8/7/20 |
| J |
| 59,072 | A | $0 | 59,072 | I | AMK 2014 LLC held by the Abby Miller King 2020 GRAT |
Class B Common Stock | 8/7/20 |
| J |
| 29,569 | D | $0 | 0 | I | MS 2014 LLC as held by The Marni Spencer 2018 GRAT |
Class B Common Stock | 8/7/20 |
| J |
| 29,569 | A | $0 | 29,569 | I | MS 2014 LLC as held by Alan B. Miller |
Class B Common Stock | 8/7/20 |
| J |
| 29,503 | D | $0 | 24,180 | I | MS 2014 LLC as held by The Marni Spencer 2019 GRAT |
Class B Common Stock | 8/7/20 |
| J |
| 29,503 | A | $0 | 59,072 | I | MS 2014 LLC as held by Alan B. Miller |
Class B Common Stock | 8/7/20 |
| J |
| 59,072 | D | $0 | 0 | I | MS 2014 LLC as held by Alan B. Miller |
Class B Common Stock | 8/7/20 |
| J |
| 59,072 | A | $0 | 59,072 | I | MS 2014 LLC as held by The Marni Spencer 2020 GRAT |
Class B Common Stock | 8/7/20 |
| J |
| 74,660 | D | $0 | 0 | I | MDM 2014 LLC as held by The Marc Daniel Miller 2018 GRAT |
Class B Common Stock | 8/7/20 |
| J |
| 74,660 | A | $0 | 74,660 | I | MDM 2014 LLC as held by Alan B. Miller |
Class B Common Stock | 8/7/20 |
| J |
| 55,712 | D | $0 | 45,621 | I | MDM 2014 LLC as held by The Marc Daniel Miller 2019 GRAT |
Class B Common Stock | 8/7/20 |
| J |
| 55,712 | A | $0 | 130,372 | I | MDM 2014 LLC as held by Alan B. Miller |
Class B Common Stock | 8/7/20 |
| J |
| 130,372 | D | $0 | 0 | I | MDM 2014 LLC as held by Alan B. Miller |
Class B Common Stock | 8/7/20 |
| J |
| 130,372 | A | $0 | 130,372 | I | MDM 2014 LLC as held by The Marc Daniel Miller 2020 GRAT |
Class B Common Stock |
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|
|
|
|
| 141,209 | D |
|
Class B Common Stock |
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| 16,748 | I | AMK 2014 LLC held by The Abby Danielle Miller 2002 Trust |
Class B Common Stock |
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|
| 24,007 | I | MDM 2014 LLC held by The Marc Daniel Miller 2002 Trust |
Class B Common Stock |
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|
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| 16,748 | I | MS 2014 LLC held by The Marni Spencer 2002 Trust |
Class B Common Stock |
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|
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|
| 22,815 | I | The Abby Danielle Miller 2002 Trust |
Class B Common Stock |
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| 55,763 | I | The Abby Miller King 2011 Family Trust |
Class B Common Stock |
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|
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| 44,110 | I | The Marc Daniel Miller 2002 Trust |
Class B Common Stock |
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| 59,900 | I | The Marc Daniel Miller 2011 Family Trust |
Class B Common Stock |
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| 43,247 | I | The Marni Spencer 2002 Trust |
Class B Common Stock |
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| 55,763 | I | The Marni Spencer 2011 Family Trust |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) |
1. Title of Derivative Security (Instr.
3)
| 2. Conversion or Exercise Price of Derivative Security
| 3. Transaction Date
(Month/Day/Year) | 3A. Deemed Execution Date, if any
(Month/Day/Year) | 4. Transaction Code (Instr.
8)
| 5.
Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr.
3, 4 and 5)
| 6. Date Exercisable and Expiration Date
(Month/Day/Year) | 7. Title and Amount of Securities Underlying Derivative Security (Instr.
3 and 4)
| 8. Price of Derivative Security (Instr.
5)
| 9.
Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr.
4)
| 10. Ownership Form: Direct (D) or Indirect (I) (Instr.
4)
| 11. Nature of Indirect Beneficial Ownership (Instr.
4)
|
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Class A Common Stock | | 8/7/20 |
| J |
|
| 29,569 | | | Class B Common Stock | 29,569 | $0 | 0 | I | AMK 2014 LLC as held by The Abby Miller King 2018 GRAT |
Class A Common Stock | | 8/7/20 |
| J |
| 29,569 |
| | | Class B Common Stock | 29,569 | $0 | 29,569 | I | AMK 2014 LLC as held by Alan B. Miller |
Class A Common Stock | | 8/7/20 |
| J |
|
| 29,503 | | | Class B Common Stock | 29,503 | $0 | 24,180 | I | AMK 2014 LLC as held by the Abby Miller King 2019 GRAT |
Class A Common Stock | | 8/7/20 |
| J |
| 29,503 |
| | | Class B Common Stock | 29,503 | $0 | 59,072 | I | AMK 2014 LLC as held by Alan B. Miller |
Class A Common Stock | | 8/7/20 |
| J |
|
| 59,072 | | | Class B Common Stock | 59,072 | $0 | 0 | I | AMK 2014 LLC as held by Alan B. Miller |
Class A Common Stock | | 8/7/20 |
| J |
| 59,072 |
| | | Class B Common Stock | 59,072 | $0 | 59,072 | I | AMK 2014 LLC held by the Abby Miller King 2020 GRAT |
Class A Common Stock | | 8/7/20 |
| J |
|
| 29,569 | | | Class B Common Stock | 29,569 | $0 | 0 | I | MS 2014 LLC as held by The Marni Spencer 2018 GRAT |
Class A Common Stock | | 8/7/20 |
| J |
| 29,569 |
| | | Class B Common Stock | 29,569 | $0 | 29,569 | I | MS 2014 LLC as held by Alan B. Miller |
Class A Common Stock | | 8/7/20 |
| J |
|
| 29,503 | | | Class B Common Stock | 29,503 | $0 | 24,180 | I | MS 2014 LLC as held by The Marni Spencer 2019 GRAT |
Class A Common Stock | | 8/7/20 |
| J |
| 29,503 |
| | | Class B Common Stock | 29,503 | $0 | 59,072 | I | MS 2014 LLC as held by Alan B. Miller |
Class A Common Stock | | 8/7/20 |
| J |
|
| 59,072 | | | Class B Common Stock | 59,072 | $0 | 0 | I | MS 2014 LLC as held by Alan B. Miller |
Class A Common Stock | | 8/7/20 |
| J |
| 59,072 |
| | | Class B Common Stock | 59,072 | $0 | 59,072 | I | MS 2014 LLC as held by The Marni Spencer 2020 GRAT |
Class A Common Stock | | 8/7/20 |
| J |
|
| 55,996 | | | Class B Common Stock | 55,996 | $0 | 0 | I | MDM 2014 LLC as held by the Marc Daniel Miller 2018 GRAT |
Class A Common Stock | | 8/7/20 |
| J |
| 55,996 |
| | | Class B Common Stock | 55,996 | $0 | 55,996 | I | MDM 2014 LLC as held by Alan B. Miller |
Class A Common Stock | | 8/7/20 |
| J |
|
| 41,783 | | | Class B Common Stock | 41,783 | $0 | 34,216 | I | MDM 2014 LLC as held by the Marc Daniel Miller 2019 GRAT |
Class A Common Stock | | 8/7/20 |
| J |
| 41,783 |
| | | Class B Common Stock | 41,783 | $0 | 97,779 | I | MDM 2014 LLC as held by Alan B. Miller |
Class A Common Stock | | 8/7/20 |
| J |
|
| 97,779 | | | Class B Common Stock | 97,779 | $0 | 0 | I | MDM 2014 LLC as held by Alan B. Miller |
Class A Common Stock | | 8/7/20 |
| J |
| 97,779 |
| | | Class B Common Stock | 97,779 | $0 | 97,779 | I | MDM 2014 LLC as held by The Marc Daniel Miller 2020 GRAT |
Class A Common Stock | |
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| | | Class B Common Stock | 532,194 |
| 532,194 | I | A. Miller Family, LLC |
Class A Common Stock | |
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| | | Class B Common Stock | 61,500 |
| 61,500 | I | Abby Danielle Miller Subtrust u/ Miller Family 2017 Trust |
Class A Common Stock | |
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| | | Class B Common Stock | 118,900 |
| 118,900 | I | By The Abby Miller King Family 2012 Trust |
Class A Common Stock | |
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| | | Class B Common Stock | 118,900 |
| 118,900 | I | By The Marc Daniel Miller Family 2012 Trust |
Class A Common Stock | |
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| | | Class B Common Stock | 118,900 |
| 118,900 | I | By The Marni Spencer Family 2012 Trust |
Class A Common Stock | |
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| | | Class B Common Stock | 61,500 |
| 61,500 | I | Marc Daniel Miller Subtrust u/ Miller Family 2017 Trust |
Class A Common Stock | |
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| | | Class B Common Stock | 61,500 |
| 61,500 | I | Marni Spencer Subtrust u/ Miller Family 2017 Trust |
Class A Common Stock | |
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| | | Class B Common Stock | 18,005 |
| 18,005 | I | MDM 2014 LLC held by The Marc Daniel Miller 2002 Trust |
Class A Common Stock | |
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| | | Class B Common Stock | 16,748 |
| 16,748 | I | MS 2014 LLC held by The Marni Spencer 2002 Trust |
Class A Common Stock | |
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| | | Class B Common Stock | 99,063 |
| 99,063 | I | The Abby Danielle Miller 2002 Trust |
Class A Common Stock | |
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| | | Class B Common Stock | 139,195 |
| 139,195 | I | The Marc Daniel Miller 2002 Trust |
Class A Common Stock | |
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| | | Class B Common Stock | 99,063 |
| 99,063 | I | The Marni Spencer 2002 Trust |
Explanation of Responses: |
| /s/ Steve Filton, Attorney in Fact for Marc D. Miller | 8/11/20 |
| ** Signature of Reporting Person | Date |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. |
* If the form is filed by more than one reporting person,
see
Instruction
4
(b)(v). |
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations
See
18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure. |
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |
____________ Transaction Code: |
J | Other acquisition or disposition. |
|