-----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, A291Mv6kR4aTteYUd2d+UpArgXb4awDKtctCdibZEg3xBnGp1appEGz+HOXvx9pb KNB3h0NxSDeL/G3MYeOycA== 0000950116-03-003548.txt : 20030814 0000950116-03-003548.hdr.sgml : 20030814 20030814125315 ACCESSION NUMBER: 0000950116-03-003548 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20030814 FILED AS OF DATE: 20030814 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MCCUSKER FLETCHER JAY CENTRAL INDEX KEY: 0001256570 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 000-50364 FILM NUMBER: 03845201 MAIL ADDRESS: STREET 1: 5524 EAST FOURTH STREET CITY: TUCSON STATE: AZ ZIP: 85711 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: PROVIDENCE SERVICE CORP CENTRAL INDEX KEY: 0001220754 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-SOCIAL SERVICES [8300] IRS NUMBER: 860845127 STATE OF INCORPORATION: DE FISCAL YEAR END: 0629 BUSINESS ADDRESS: STREET 1: 5524 E. FOURTH ST. CITY: TUSCON STATE: AZ ZIP: 85711 BUSINESS PHONE: 5207487108 MAIL ADDRESS: STREET 1: 5524 E. FOURTH ST. CITY: TUSCON STATE: AZ ZIP: 85711 3 1 p326553_ex.xml FORM 3 X0201 3 2003-08-14 0 0001220754 PROVIDENCE SERVICE CORP PRSC 0001256570 MCCUSKER FLETCHER JAY 5524 EAST FOURTH STREET TUCSON AZ 85711 1 1 1 0 Chief Executive Officer Class A Common Stock 519898 D Class A Common Stock 100000 I By grantor retained annuity trust This amount takes into account a 3.5-for-1 reverse stock split effected on May 19, 2003. The filing of this Statement shall not be construed as an admission (a) that the person filing this Statement is, for the purposes of Section 16 of the Securities Exchange Act of 1934 (as amended), the beneficial owner of any equity securities covered by this Statement, or (b) that this Statement is legally required to be filed by such person. Fletcher Jay McCusker 2003-08-13 -----END PRIVACY-ENHANCED MESSAGE-----