-----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, J1NapGsmXieY6Jydf2NQ7J+kgcZ5XxDLdQtwgyysPxDOGfNqP/IqRrWBeR1TVsWI MnGVTL+szOZH6YGcDeRZvw== 0001209191-05-021200.txt : 20050419 0001209191-05-021200.hdr.sgml : 20050419 20050419163447 ACCESSION NUMBER: 0001209191-05-021200 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20050415 FILED AS OF DATE: 20050419 DATE AS OF CHANGE: 20050419 ISSUER: 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 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 STREET 2: SUITE 180 CITY: BRENTWOOD STATE: TN ZIP: 37207 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: PEMBERTON THOMAS PUAL II CENTRAL INDEX KEY: 0001221696 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 333-34421 FILM NUMBER: 05759615 MAIL ADDRESS: STREET 1: 105 WESTWOOD PLACE CITY: BRENTWOOD STATE: TN ZIP: 37027 4 1 bna94295_bna03pemberton.xml MAIN DOCUMENT DESCRIPTION X0202 4 2005-04-15 1 0001044942 PROVINCE HEALTHCARE CO PRV 0001221696 PEMBERTON THOMAS PUAL II 105 WESTWOOD PLACE BRENTWOOD TN 37027 0 1 0 0 Reg. VP - Eastern Div. Common Stock 2005-04-15 4 D 0 1563 D 0 D Common Stock 2005-04-15 4 D 0 2000 D 0 I Through IRA Stock Option 7.71 2005-04-15 4 D 0 48000 16.65 D 2013-03-11 Common Stock 48000 0 D Stock Option 15.75 2005-04-15 4 D 0 38000 8.61 D 2014-03-10 Common Stock 38000 0 D Disposed of pursuant to the Agreement and Plan of Merger between issuer and LifePoint Hospitals, Inc. ("LifePoint") in exchange for cash in the amount of $17,779 plus 456 shares of LifePoint. Disposed of pursuant to the Agreement and Plan of Merger between issuer and LifePoint Hospitals, Inc. ("LifePoint") in exchange for cash in the amount of $22,750 plus 583 shares of LifePoint. This option was canceled in the merger in exchange for a cash payment equal to the product of (i) the number of shares of the issuer's common stock subject to the award; and (ii) the excess, if any, of the per share merger consideration over the exercise price per share of the award. /s/ Tom Pemberton 2005-04-18 -----END PRIVACY-ENHANCED MESSAGE-----