SEC Form 4 · accession 0001127602-15-025776
UNIVERSAL HEALTH REALTY INCOME TRUST · UHT
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Alan B Miller
Officer — Chairman, President, and CEO · Other
Period of report
Aug 25, 2015
Accepted (ET)
Aug 25, 2015 · 2:43 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000798783
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Shares Of Beneficial Interest | Aug 25, 2015 | M | 5,000 | $34.90 | A | 109,730 | D | |
| Shares Of Beneficial InterestF1 | holding | — | — | — | 42,000 | I | By The Alan B. Miller Family Foundation |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Option To Purchase Shares Of Beneficial InterestF2 | $34.90 | Aug 25, 2015 | M | 5,000 | D | — | Sep 1, 2015 | Shares Of Beneficial Interest | 5,000 | 0 | D |
Explanation of responses
- F1Mr. Miller disclaims beneficial ownership of these securities, and this report shall not be deemed an admission that Mr. Miller is the beneficial owner of these securities for purposes of Section 16 or for any other purpose.
- F2The option vested ratably on each of 9/1/2006, 9/1/2007, 9/1/2008 and 9/1/2009. Optionee was also granted Dividend Equivalent Rights on the same terms as the Option, pursuant to which the holder will receive the accrued cash dividends upon exercise of the Dividend Equivalent Rights.