3 1 g78176de3.htm PROVINCE HEALTHCARE COMPANY / KEVIN POORTEN e3
 

FORM 3

U.S. SECURITIES AND EXCHANGE COMMISSION

Washington, DC 20549
         
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(f) of the Investment Company Act of 1940
                 
1. Name and Address of Reporting Person(1)   2. Date of Event Requiring Statement
(Month/Day/Year)
8/22/02 		  4. Issuer Name and Ticker or Trading Symbol
Province Healthcare Company (PRV)
(Last)(First)(Middle)
Poorten, Kevin
     
5. Relationship of Reporting Person to Issuer

(Check all applicable)
  		      6. If Amendment, Date of Original
(Month/Day/Year)
(Street)
105 Westwood Place, Suite 400
  3. IRS Identification Number of Reporting Person, if an Entity
(Voluntary)
  		  o Director
x  Officer (give title below)
Regional VP — Central Region 		  o 10% Owner
o  Other (specify below)
  		   
(City)(State)(Zip)
Brentwood, TN 37027
              7. Individual or Joint/Group Filing (Check applicable line)
x  Form Filed by One Reporting Person
o  Form Filed by
More Than
One Reporting
Person
TABLE I — NON-DERIVATIVE SECURITIES BENEFICIALLY OWNED
             
1. Title of Security
(Instr. 4) 		  2. Amount of Securities Beneficially Owned
(Instr. 4) 		  3. Ownership Form:
Direct (D) or Indirect (I) (Instr. 5) 		  4. Nature of Indirect Beneficial Ownership (Instr.  5)
Common Stock
  376   D    
 
           
 
           
 
           
 
           
 
           
 
           
 
           

(1)  If the form is filed by more than one Reporting Person, see Instruction 5(b)(v).

Reminder:  Report on a separate line for each class of securities beneficially owned directly or indirectly.

(Print or Type Responses)

(Over)

 

FORM 3 (continued)

Table  II — Derivative Securities Beneficially Owned

(e.g., Puts, Calls, Warrants, Options, Convertible Securities)
                             
1. Title of Derivative Security
(Instr. 4)
  		  2. Date Exercisable
and Expiration Date
(Month/ Day/ Year)
  		  3. Title and Amount of Securities Underlying Derivative Securities
(Instr. 4)
  		  4. Conversion or Exercise Price of Derivative Security
  		  5. Ownership Form of Derivative Security:

Direct (D) or Indirect (I) (Instr. 5)
  		  6. Nature of Indirect Beneficial Ownership (Instr. 5)
 
   
Date
Exercisable 		 
Expiration
Date 		 

Title 		  Amount or
Number of Shares 		           
Stock Options   See Note 1   5/7/08   Common Stock   4,625   $11.555 per share   D    
Stock Options   See Note 2   2/25/09   Common Stock   5,272   $6.722 per share   D    
Stock Options   See Note 3   5/3/10   Common Stock   30,001   $11.50 per share   D    
Stock Options   2/22/01   2/22/11   Common Stock   3,641   $16.709 per share   D    
Stock Options   See Note 4   5/15/11   Common Stock   21,940   $16.40 per share   D    
Stock Options   3/13/02   3/13/12   Common Stock   36,247   $21.08 per share   D    
Stock Options   See Note 5   8/21/12   Common Stock   20,896   $18.20 per share   D    
 
                           
 
                           
  Explanation of Responses:

Note 1: 1,475 options are exercisable on 5/7/02 and 3,150 options are exercisable on 5/7/03

Note 2: 262 options are exercisable on 2/25/02 and 2,505 options are exercisable on each of 2/25/03 and 2/25/04
Note 3: 3,000 options are exercisable on 5/3/02, 9,000 options are exercisable on each of 5/3/03 and 5/3/04 and 9,001 options are exercisable on 5/3/05
Note 4: 4,388 options are exercisable on each of 5/15/02, 5/15/03, 5/15/04, and 5/15/05
Note 5: 4,179 options are exercisable on each of 8/21/03, 8/21/04, 8/21/05, 8/21/06 and 4,180 options are exercisable on 8/21/07

    /s/ Kevin P. Poorten   8/29/02
   
 
    Signature of Reporting Person  (1)   Date

         (1) Intentional misstatements or omissions of facts constitute Federal Criminal Violations.
See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).

         Note. File three copies of this form, one of which must be manually signed. If space provided

is insufficient, see Instruction 6 for procedure.
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