-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, BnmGHeybt3f2U0eIYs6iGpy45YOb2+/DNXRwjEaNu+fBmeT3rxUsUc0Y3fb4iWbB mDcUswp5J5GFG76U4eHmPg== 0000950144-01-508911.txt : 20020410 0000950144-01-508911.hdr.sgml : 20020410 ACCESSION NUMBER: 0000950144-01-508911 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20011029 FILED AS OF DATE: 20011113 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: 1784373 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 g72736e4.txt PROVINCE HEALTHCARE COMPANY/HOWARD T. WALL III - ------ FORM 4 - ------ UNITED STATES SECURITIES AND EXCHANGE COMMISSION ------------------------------ Washington, D.C. 20549 OMB APPROVAL ------------------------------ STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OMB Number: 3235-0287 [ ] Check this box if no Expires: December 31, 2000 longer subject to Filed pursuant to Section 16(a) of the Securities Estimated average burden Section 16. Form 4 Exchange Act of 1934, Section 17(a) of the hours per response.......0.5 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
- ------------------------------------------------------------------------------------------------------------------------------------ | 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. | Providence 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| | 105 Westwood Place, Suite 400 | Person, if an entity | 10/2001 | title below) | | | (Voluntary) | | below) | | | | | Senior Vice President, General | | | | | Counsel and Secretary | |-------------------------------------------| |--------------------|--------------------------------------| | (Street) | | 5. If Amendment, |7. Individual or Joint/Group Filing | | | | Date of Original| (Check Applicable Line) | | Brentwood, TN 37027 | | (Month/Year) | [X] Form filed by One | | | | | 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) | |---------------------|-------------------|-------|------|------------|-------|------|--------------------|-------------|----------| | Common Stock | 10/29/01 | M | | 3,000 | A |$10.667 | | | | | | | | | |per | 7,672 | D | | | | | | | | |share | | | | |---------------------|-------------------|-------|------|------------|-------|------|--------------------|-------------|----------| | | | | | | | | | | | |---------------------|-------------------|-------|------|------------|-------|------|--------------------|-------------|----------| | | | | | | | | | | | |---------------------|-------------------|-------|------|------------|-------|------|--------------------|-------------|----------| | | | | | | | | | | | |---------------------|-------------------|-------|------|------------|-------|------|--------------------|-------------|----------| | | | | | | | | | | | |---------------------|-------------------|-------|------|------------|-------|------|--------------------|-------------|----------| | | | | | | | | | | | |---------------------|-------------------|-------|------|------------|-------|------|--------------------|-------------|----------| | | | | | | | | | | | |---------------------|-------------------|-------|------|------------|-------|------|--------------------|-------------|----------| | | | | | | | | | | | - ------------------------------------------------------------------------------------------------------------------------------------
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 information contained in this form are not required to respond unless the form displays a currently valid OMB control number. (Over) SEC 1474 (3-99)
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 per | 10/29/01 | M | | | 3,000 | 2/10/01|2/10/08 | Common | 3,000 | | | | 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) | | | | | | |---------------------|-------------------------------|----------------------| | 19,394 | D | | |---------------------|-------------------------------|----------------------| | | | | |---------------------|-------------------------------|----------------------| | | | | |---------------------|-------------------------------|----------------------| | | | | |---------------------|-------------------------------|----------------------| | | | | |---------------------|-------------------------------|----------------------| | | | | - ------------------------------------------------------------------------------ Explanation of Responses: ** Intentional misstatements or omissions of facts constitute Federal Criminal /s/ Howard T. Wall III 11/12/01 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. Page 2 If space is insufficient, see Instruction 6 for procedure. SEC 1474 (3-99)
Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. -----END PRIVACY-ENHANCED MESSAGE-----