SEC Form 4 · accession 0001127602-19-010358

UNIVERSAL HEALTH SERVICES INC · UHS

Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗

Reporting owner

Marc D Miller

Officer — President · Director

Period of report

Mar 5, 2019

Accepted (ET)

Mar 7, 2019 · 11:02 am EST

Rule 10b5-1 plan

unknown — predates the checkbox

Issuer CIK

0000352915

Table I — non-derivative securities

Security	Date	Code	Shares	Price	A/D	Owned after	D/I	Nature of ownership
Class B Common Stock	Mar 5, 2019	J	31,319	$0.00	D	0	I	AMK 2014 LLC held by The Abby Miller King 2017 GRAT
Class B Common Stock	Mar 5, 2019	J	31,319	$0.00	A	31,319	I	AMK 2014 LLC as held by Alan B. Miller
Class B Common Stock	Mar 5, 2019	J	31,319	$0.00	D	0	I	MS 2014 LLC held by The Marni Spencer 2017 GRAT
Class B Common Stock	Mar 5, 2019	J	31,319	$0.00	A	31,319	I	MS 2014 LLC as held by Alan B. Miller
Class B Common Stock	Mar 5, 2019	J	44,896	$0.00	D	0	I	MDM 2014 LLC held by The Marc Daniel Miller 2017 GRAT
Class B Common Stock	Mar 5, 2019	J	44,896	$0.00	A	44,896	I	MDM 2014 LLC as held by Alan B. Miller
Class B Common Stock	holding	—	—		—	135,237	D
Class B Common Stock	holding	—	—		—	0	I	AMK 2014 LLC
Class B Common Stock	holding	—	—		—	16,748	I	AMK 2014 LLC held by The Abby Danielle Miller 2002 Trust
Class B Common Stock	holding	—	—		—	51,933	I	AMK 2014 LLC held by the Abby Miller King 2018 GRAT
Class B Common Stock	holding	—	—		—	131,097	I	MDM 2014 LLC as held by The Marc Daniel Miller 2018 GRAT
Class B Common Stock	holding	—	—		—	24,007	I	MDM 2014 LLC held by The Marc Daniel Miller 2002 Trust
Class B Common Stock	holding	—	—		—	51,933	I	MS 2014 LLC as held by The Marni Spencer 2018 GRAT
Class B Common Stock	holding	—	—		—	16,748	I	MS 2014 LLC held by The Marni Spencer 2002 Trust
Class B Common Stock	holding	—	—		—	22,815	I	The Abby Danielle Miller 2002 Trust
Class B Common Stock	holding	—	—		—	55,763	I	The Abby Miller King 2011 Family Trust
Class B Common Stock	holding	—	—		—	44,110	I	The Marc Daniel Miller 2002 Trust
Class B Common Stock	holding	—	—		—	59,900	I	The Marc Daniel Miller 2011 Family Trust
Class B Common Stock	holding	—	—		—	43,247	I	The Marni Spencer 2002 Trust
Class B Common Stock	holding	—	—		—	55,763	I	The Marni Spencer 2011 Family Trust

Table II — derivative securities

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
Class A Common Stock^F2,F3,F4	—	Mar 5, 2019	J	31,319	D	—	—	Class B Common Stock	31,319	0	I
Class A Common Stock^F2,F5,F6	—	Mar 5, 2019	J	31,319	A	—	—	Class B Common Stock	31,319	31,319	I
Class A Common Stock^F2,F3,F4	—	Mar 5, 2019	J	31,319	D	—	—	Class B Common Stock	31,319	0	I
Class A Common Stock^F2,F5,F6	—	Mar 5, 2019	J	31,319	A	—	—	Class B Common Stock	31,319	31,319	I
Class A Common Stock^F2,F3,F4	—	Mar 5, 2019	J	33,671	D	—	—	Class B Common Stock	33,671	0	I
Class A Common Stock^F2,F5,F6	—	Mar 5, 2019	J	33,671	A	—	—	Class B Common Stock	33,671	33,671	I
Class A Common Stock^F2,F3,F4	—	holding	—	—	—	—	—	Class B Common Stock	160,563	160,563	I
Class A Common Stock^F2,F3,F4	—	holding	—	—	—	—	—	Class B Common Stock	200,695	200,695	I
Class A Common Stock^F2,F3,F4	—	holding	—	—	—	—	—	Class B Common Stock	160,563	160,563	I
Class A Common Stock^F2,F3,F4	—	holding	—	—	—	—	—	Class B Common Stock	532,194	532,194	I
Class A Common Stock^F7,F3,F4	—	holding	—	—	—	—	—	Class B Common Stock	51,933	51,933	I
Class A Common Stock^F2,F3,F4	—	holding	—	—	—	—	—	Class B Common Stock	16,748	16,748	I
Class A Common Stock^F7,F3,F4	—	holding	—	—	—	—	—	Class B Common Stock	118,900	118,900	I
Class A Common Stock^F7,F3,F4	—	holding	—	—	—	—	—	Class B Common Stock	118,900	118,900	I
Class A Common Stock^F7,F3,F4	—	holding	—	—	—	—	—	Class B Common Stock	118,900	118,900	I
Class A Common Stock^F7,F3,F4	—	holding	—	—	—	—	—	Class B Common Stock	98,324	98,324	I
Class A Common Stock^F2,F3,F4	—	holding	—	—	—	—	—	Class B Common Stock	18,005	18,005	I
Class A Common Stock^F7,F3,F4	—	holding	—	—	—	—	—	Class B Common Stock	51,933	51,933	I
Class A Common Stock^F2,F3,F4	—	holding	—	—	—	—	—	Class B Common Stock	16,748	16,748	I

Explanation of responses

F1On March 5, 2019, The Marc Daniel Miller 2017 GRAT distributed a 22.44772% interest in MDM 2014 LLC to Alan B. Miller, The Abby Miller King 2017 GRAT distributed a 31.32029% interest in AMK 2014 LLC to Alan B. Miller, and The Marni Spencer 2017 GRAT distributed a 31.32029% interest in AMK 2014 LLC to Alan B. Miller. The shares reflected represent the amount of shares held by each LLC as represented by the percentage LLC interests distributed. Mr. Miller's pecuniary interest in these shares is unchanged. All distributions hereinbefore described were made pursuant to the terms of the Trust Agreement creating each 2017 GRAT. Each 2017 GRAT is now terminated.
F2These shares are convertible to Class B Common Stock on a share for share basis.
F3Immediately.
F4Not Applicable.
F5Immediately
F6Not Applicable
F7The Class A Common Stock is convertible into Class B Common Stock on a share for share basis.