0000950144-01-507695.txt : 20011018 0000950144-01-507695.hdr.sgml : 20011018 ACCESSION NUMBER: 0000950144-01-507695 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20010926 FILED AS OF DATE: 20011010 COMPANY DATA: COMPANY CONFORMED NAME: WALL HOWARD T III CENTRAL INDEX KEY: 0001057317 STANDARD INDUSTRIAL CLASSIFICATION: [] OFFICER FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: 109 WESTPARK DR STREET 2: STE 180 CITY: BRENTWOOD STATE: TN ZIP: 37027 MAIL ADDRESS: STREET 1: 109 WESTPARK DR STREET 2: STE 180 CITY: BRENTWOOD STATE: TN ZIP: 37027 FORMER COMPANY: FORMER CONFORMED NAME: WALL HOWARD I III DATE OF NAME CHANGE: 19980309 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: PROVINCE HEALTHCARE CO CENTRAL INDEX KEY: 0001044942 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-GENERAL MEDICAL & SURGICAL HOSPITALS, NEC [8062] IRS NUMBER: 621710772 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-23639 FILM NUMBER: 1756290 BUSINESS ADDRESS: STREET 1: 105 WESTPARK DR STREET 2: STE 400 CITY: BRENTWOOD STATE: TN ZIP: 37027 BUSINESS PHONE: 6153701377 MAIL ADDRESS: STREET 1: 105 WESTPARK DR SUITE 180 STREET 2: 105 WESTPARK DR SUITE 180 CITY: BRENTWOOD STATE: TN ZIP: 37207 4 1 g72094ae4.txt PROVINCE HEALTHCARE COMPANY/HOWARD T. WALL III 1 ------ FORM 4 ------ UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, DC 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP [ ] Check this box if no longer subject to Filed pursuant to Section 16(a) of the Securities Section 16. Form 4 Exchange Act of 1934, Section 17(a) of the or Form 5 obligations Public Utility Holding Company Act of 1935 may continue. See or Section 30(f) of the Investment Company Instruction 1(b). Act of 1940 (Print or Type Responses) ------------------------------------------------------------------------------------------------------------------------------------ | 1. Name and Address of Reporting Person* | 2. Issuer Name and Ticker or Trading Symbol |6. Relationship of Reporting Person(s)| | Wall, III Howard T. | Province Healthcare Company (PRHC) | to Issuer (check all applicable) | |--------------------------------------------|----------------------------------------------| | | (Last) (First) (Middle) | 3. I.R.S Identification | 4. Statement for | [ ] Director [ ] 10% Owner | | | Number of Reporting | Month/Year | [X] Officer (give [ ] Other (specify| | | Person, if an entity | | title below) below) | | | (Voluntary) | 9/2001 | Senior Vice President, General | | 105 Westwood Place, Suite 400 | | | Counsel and Secretary | |--------------------------------------------| |--------------------|--------------------------------------| | (Street) | | 5. If Amendment, |7. Individual or Joint/Group Filing | | | | Date of Original| (Check Applicable Line) | | | | (Month/Year) | [X] Form filed by One | | Brentwood, TN 37027 | | | Reporting Person | |--------------------------------------------|----------------------------------------------| [ ] Form filed by More than | | (City) (State) (Zip) | | One Reporting Person | | | | | |----------------------------------------------------------------------------------------------------------------------------------| | TABLE I -- NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED | |----------------------------------------------------------------------------------------------------------------------------------| |1. Title of Security |2. Transaction |3. Transac- |4. Securities Acquired (A) |5. Amount of Se- |6. Owner- |7. Nature | | (Instr. 3) | Date | tion Code | or Disposed of (D) | curities Benefi-| ship | of In- | | | (Month/Day/ | (Instr. 8) | | cially Owned at | Form: | direct | | | Year) | | | End of Month | Direct | Benefi-| | | | | (Instr. 3, 4 and 5) | (Instr. 3 and 4)| (D) or | cial | | | |--------------|----------------------------| | Indirect | Owner- | | | | Code | V | Amount | (A) or| Price | | (I) | ship | | | | | | | (D) | | | (Instr. 4)| (Instr.| | | | | | | | | | | 4) | |---------------------|-------------------|-------|------|------------|-------|-------|-------------------|-------------|----------| | | | | | | |$10.667| 4,672 (See | | | | Common Stock | 9/26/01 | M | | 3,000 | A | per | Note 1) | D | | | | | | | | | share | | | | |---------------------|-------------------|-------|------|------------|-------|-------|-------------------|-------------|----------| | | | | | | |$10.083| | | | | Common Stock | 9/26/01 | M | | 4,770 | A | per | 4,672 | D | | | | | | | | | share | | | | |---------------------|-------------------|-------|------|------------|-------|-------|-------------------|-------------|----------| | | | | | | |$13.417| | | | | Common Stock | 9/26/01 | M | | 2,230 | A | per | 4,672 | D | | | | | | | | | share | | | | |---------------------|-------------------|-------|------|------------|-------|-------|-------------------|-------------|----------| | | | | | | |$36.880| | | | | Common Stock | 9/26/01 | S | | 5,000 | D | per | 4,672 | D | | | | | | | | | share | | | | |---------------------|-------------------|-------|------|------------|-------|-------|-------------------|-------------|----------| | | | | | | |$36.960| | | | | Common Stock | 9/26/01 | S | | 5,000 | D | per | 4,672 | D | | | | | | | | | share | | | | |---------------------|-------------------|-------|------|------------|-------|-------|-------------------|-------------|----------| | Note 1: End of period holdings have been updated to include 1,567 shares of Common Stock acquired under the 1998 Employee Stock | | Purchase Plan. | |----------------------------------------------------------------------------------------------------------------------------------| 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). Potential persons who are to respond to the collection of (Over) information contained in this form are not required to SEC 1474 (3-99) respond unless the form displays a currently valid OMB control number.
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FORM 4 (CONTINUED) TABLE II -- DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED (E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES) ------------------------------------------------------------------------------------------------------------------------------------ |1. Title of Derivative | 2. Conver- |3. Trans- |4. Trans- |5. Number of | 6. Date Exer- |7. Title and Amount |8. Price | | Security | sion or | action | action | Derivative | cisable and | of Underlying | of | | (Instr. 3) | Exercise | Date | Code | Securities | Expiration | Securities | Deriv- | | | Price of | (Month/| (Instr.| Acquired (A) | Date | (Instr. 3 and 4) | ative | | | Deriv- | Day/ | 8) | or Disposed | (Month/Day/ | | Secur- | | | ative | Year) | | of (D) | Year) | | ity | | | Security | | | (Instr. 3, | | | (Instr. 5)| | | | | | 4, and 5) |-----------------|--------------------| | | | | | | | Date |Expira- | | Amount or| | | | | |----------|----------------| Exer- |tion | Title | Number of| | | | | | Code| V | (A) | (D) | cisable|Date | | Shares | | |-----------------------|--------------|----------|-----|----|-------|--------|--------|--------|--------|-----------|-------------| | Employee Stock Options| $10.667 | 9/26/01 | M | | | 3,000 |2/10/01 |2/10/08 | Common | 3,000 | | | | per share | | | | | | | | Stock | | | |-----------------------|--------------|----------|-----|----|-------|--------|--------|--------|--------|-----------|-------------| | Employee Stock Options| $10.083 | 9/26/01 | M | | | 4,770 |2/25/01 |2/25/09 | Common | 4,770 | | | | per share | | | | | | | | Stock | | | |-----------------------|--------------|----------|-----|----|-------|--------|--------|--------|--------|-----------|-------------| | Employee Stock Options| $13.417 | 9/26/01 | M | | | 2,230 |3/01/00 |3/01/10 | Common | 2,230 | | | | per share | | | | | | | | Stock | | | |-----------------------|--------------|----------|-----|----|-------|--------|--------|--------|--------|-----------|-------------| | | | | | | | | | | | | | |-----------------------|--------------|----------|-----|----|-------|--------|--------|--------|--------|-----------|-------------| | | | | | | | | | | | | | |-----------------------|--------------|----------|-----|----|-------|--------|--------|--------|--------|-----------|-------------| | | | | | | | | | | | | | ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------ | 9. Number of | 10. Ownership | 11. Nature of | | Derivative | Form of | Indirect | | Securities | Derivative | Beneficial | | Beneficially | Security: | Ownership | | Owned at End | Direct (D) | (Instr. 4) | | of Month | or Indirect (I) | | | (Instr. 4) | (Instr. 4) | | | | | | |---------------------|-------------------------------|----------------------| | 22,394 | D | | |---------------------|-------------------------------|----------------------| | 14,310 | D | | |---------------------|-------------------------------|----------------------| | 27,094 | D | | |---------------------|-------------------------------|----------------------| | | | | |---------------------|-------------------------------|----------------------| | | | | |---------------------|-------------------------------|----------------------| | | | | ------------------------------------------------------------------------------ Explanation of Responses: ** Intentional misstatements or omissions of facts constitute Federal Criminal /s/ Howard T. Wall, III 10/9/01 Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). -------------------------------- ---------- **Signature of Reporting Person Date Note. File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. Potential persons who are to respond to the collection of information contained Page 2 in this form are not required to respond unless the form displays a currently SEC 1474 (3-99) valid OMB Number.