SEC Form 4 · accession 0001127602-16-059043
UNIVERSAL HEALTH REALTY INCOME TRUST · UHT
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Timothy J Fowler
Officer — Vice President
Period of report
Aug 1, 2016
Accepted (ET)
Aug 1, 2016 · 3:48 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 1, 2016 | M | 3,000 | $59.67 | A | 20,195 | D | |
| Shares Of Beneficial Interest | Aug 1, 2016 | F | 1,837 | $59.67 | D | 18,358 | D |
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 InterestF1 | $36.53 | Aug 1, 2016 | M | 3,000 | D | — | Mar 1, 2017 | Shares Of Beneficial Interest | 3,000 | 0 | D |
Explanation of responses
- F1The option vested ratably on each of 3/1/2008, 3/1/2009, 3/1/2010 and 3/1/2011. The reporting person has also been granted Dividend Equivalent Rights on the same terms as the options, pursuant to which the reporting person will receive the accrued cash dividends upon exercise of the Dividend Equivalent Rights.