0001127602-21-027835.txt : 20211029 0001127602-21-027835.hdr.sgml : 20211029 20211029170706 ACCESSION NUMBER: 0001127602-21-027835 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211027 FILED AS OF DATE: 20211029 DATE AS OF CHANGE: 20211029 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Miller Marc D CENTRAL INDEX KEY: 0001315495 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-10765 FILM NUMBER: 211364196 MAIL ADDRESS: STREET 1: 367 SOUTH GULPH ROAD CITY: KING OF PRUSSIA STATE: PA ZIP: 19406 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: UNIVERSAL HEALTH SERVICES INC CENTRAL INDEX KEY: 0000352915 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-GENERAL MEDICAL & SURGICAL HOSPITALS, NEC [8062] IRS NUMBER: 232077891 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 367 S GULPH RD CITY: KING OF PRUSSIA STATE: PA ZIP: 19406 BUSINESS PHONE: 6107683300 MAIL ADDRESS: STREET 1: 367 S GULPH ROAD CITY: KING OF PRUSSIA STATE: PA ZIP: 19406 4 1 form4.xml PRIMARY DOCUMENT X0306 4 2021-10-27 0000352915 UNIVERSAL HEALTH SERVICES INC UHS 0001315495 Miller Marc D UNIVERSAL HEALTH SERVICES, INC. 367 SOUTH GULPH ROAD KING OF PRUSSIA PA 19406 1 1 President and CEO Class B Common Stock 2021-10-27 4 J 0 51578 0 D 78794 I MDM 2014 LLC as held by The Marc Daniel Miller 2020 GRAT Class B Common Stock 2021-10-27 4 J 0 51578 0 A 97199 I MDM 2014 LLC as held by Alan B. Miller Class B Common Stock 2021-10-27 4 J 0 23382 0 D 35690 I MS 2014 LLC as held by The Marni Spencer 2020 GRAT Class B Common Stock 2021-10-27 4 J 0 23382 0 A 47562 I MS 2014 LLC as held by Alan B. Miller Class B Common Stock 2021-10-27 4 J 0 23382 0 D 35690 I AMK 2014 LLC held by the Abby Miller King 2020 GRAT Class B Common Stock 2021-10-27 4 J 0 23382 0 A 47562 I AMK 2014 LLC as held by Alan B. Miller Class B Common Stock 2021-10-28 4 J 0 78794 126.17 D 0 I MDM 2014 LLC as held by The Marc Daniel Miller 2020 GRAT Class B Common Stock 2021-10-28 4 J 0 78794 126.17 A 175993 I MDM 2014 LLC as held by Alan B. Miller Class B Common Stock 2021-10-28 4 J 0 35690 126.17 D 0 I MS 2014 LLC as held by The Marni Spencer 2020 GRAT Class B Common Stock 2021-10-28 4 J 0 35690 126.17 A 83252 I MS 2014 LLC as held by Alan B. Miller Class B Common Stock 2021-10-28 4 J 0 35690 126.17 D 0 I AMK 2014 LLC held by the Abby Miller King 2020 GRAT Class B Common Stock 2021-10-28 4 J 0 35690 126.17 A 83252 I AMK 2014 LLC as held by Alan B. Miller Class B Common Stock 145901 D Class B Common Stock 16748 I AMK 2014 LLC held by The Abby Danielle Miller 2002 Trust Class B Common Stock 24007 I MDM 2014 LLC held by The Marc Daniel Miller 2002 Trust Class B Common Stock 16748 I MS 2014 LLC held by The Marni Spencer 2002 Trust Class B Common Stock 22815 I The Abby Danielle Miller 2002 Trust Class B Common Stock 55763 I The Abby Miller King 2011 Family Trust Class B Common Stock 44110 I The Marc Daniel Miller 2002 Trust Class B Common Stock 59900 I The Marc Daniel Miller 2011 Family Trust Class B Common Stock 43247 I The Marni Spencer 2002 Trust Class B Common Stock 55763 I The Marni Spencer 2011 Family Trust Class A Common Stock 2021-10-27 4 J 0 38684 0 D Class B Common Stock 38684 59095 I MDM 2014 LLC as held by The Marc Daniel Miller 2020 GRAT Class A Common Stock 2021-10-27 4 J 0 38684 0 A Class B Common Stock 38684 72900 I MDM 2014 LLC as held by Alan B. Miller Class A Common Stock 2021-10-27 4 J 0 23382 0 D Class B Common Stock 23382 35690 I MS 2014 LLC as held by The Marni Spencer 2020 GRAT Class A Common Stock 2021-10-27 4 J 0 23382 0 A Class B Common Stock 23382 47562 I MS 2014 LLC as held by Alan B. Miller Class A Common Stock 2021-10-27 4 J 0 23382 0 D Class B Common Stock 23382 35690 I AMK 2014 LLC held by the Abby Miller King 2020 GRAT Class A Common Stock 2021-10-27 4 J 0 23382 0 A Class B Common Stock 23382 47562 I AMK 2014 LLC as held by Alan B. Miller Class A Common Stock 2021-10-28 4 J 0 59095 126.17 D Class B Common Stock 59095 0 I MDM 2014 LLC as held by The Marc Daniel Miller 2020 GRAT Class A Common Stock 2021-10-28 4 J 0 59095 126.17 A Class B Common Stock 59095 131995 I MDM 2014 LLC as held by Alan B. Miller Class A Common Stock 2021-10-28 4 J 0 35690 126.17 D Class B Common Stock 35690 0 I MS 2014 LLC as held by The Marni Spencer 2020 GRAT Class A Common Stock 2021-10-28 4 J 0 35690 126.17 A Class B Common Stock 35690 83252 I MS 2014 LLC as held by Alan B. Miller Class A Common Stock 2021-10-28 4 J 0 35690 126.17 D Class B Common Stock 35690 0 I AMK 2014 LLC held by the Abby Miller King 2020 GRAT Class A Common Stock 2021-10-28 4 J 0 35690 126.17 A Class B Common Stock 35690 83252 I AMK 2014 LLC as held by Alan B. Miller Class A Common Stock Class B Common Stock 99063 99063 I The Marni Spencer 2002 Trust Class A Common Stock Class B Common Stock 139195 139195 I The Marc Daniel Miller 2002 Trust Class A Common Stock Class B Common Stock 99063 99063 I The Abby Danielle Miller 2002 Trust Class A Common Stock Class B Common Stock 16748 16748 I MS 2014 LLC held by The Marni Spencer 2002 Trust Class A Common Stock Class B Common Stock 18005 18005 I MDM 2014 LLC held by The Marc Daniel Miller 2002 Trust Class A Common Stock Class B Common Stock 118900 118900 I By The Marni Spencer Family 2012 Trust Class A Common Stock Class B Common Stock 61500 61500 I Marc Daniel Miller Subtrust u/ Miller Family 2017 Trust Class A Common Stock Class B Common Stock 61500 61500 I Marni Spencer Subtrust u/ Miller Family 2017 Trust Class A Common Stock Class B Common Stock 118900 118900 I By The Marc Daniel Miller Family 2012 Trust Class A Common Stock Class B Common Stock 118900 118900 I By The Abby Miller King Family 2012 Trust Class A Common Stock Class B Common Stock 16748 16748 I AMK 2014 LLC held by The Abby Danielle Miller 2002 Trust Class A Common Stock Class B Common Stock 532194 532194 I A. Miller Family, LLC Class A Common Stock Class B Common Stock 61500 61500 I Abby Danielle Miller Subtrust u/ Miller Family 2017 Trust On October 27, 2021, The Marc Daniel Miller 2020 LLC GRAT distributed 25.78899% of the MDM 2014 LLC to Alan B. Miller. Mr. Alan B. Miller's pecuniary interest in these shares is unchanged. All distributions hereinbefore described were made pursuant to the terms of the Trust Agreement creating each 2020 LLC GRAT. The MDM 2014 LLC holds 200,000 shares of Class B Common Stock and 150,000 shares of Class A Common Stock. On October 27, 2021, The Marni Spencer 2020 LLC GRAT distributed 23.38211% of the MS 2014 LLC to Alan B. Miller. Mr. Alan B. Miller's pecuniary interest in these shares is unchanged. All distributions hereinbefore described were made pursuant to the terms of the Trust Agreement creating each 2020 LLC GRAT. The MS 2014 LLC holds 100,000 shares of Class B Common Stock and 100,000 shares of Class A Common Stock. Mr. Marc D. Miller disclaims any beneficial interest in the assets of The Marni Spencer 2020 LLC GRAT. On October 27, 2021, The Abby Miller King 2020 LLC GRAT distributed 23.38211% of the AMK 2014 LLC to Alan B. Miller. Mr. Alan B. Miller's pecuniary interest in these shares is unchanged. All distributions hereinbefore described were made pursuant to the terms of the Trust Agreement creating each 2020 LLC GRAT. The AMK 2014 LLC holds 100,000 shares of Class B Common Stock and 100,000 shares of Class A Common Stock. Mr. Marc D. Miller disclaims any beneficial interest in the assets of The Abby Miller King 2020 LLC GRAT. On October 28, 2021, Alan B. Miller withdrew a 39.39690% interest in the MDM 2014 LLC (corresponding to 59,095 shares of Class A common stock and 78,794 shares of Class B common stock) from the Marc Daniel Miller 2020 LLC GRAT. In exchange for the MDM 2014 LLC interests, Alan B. Miller contributed to the Marc Daniel Miller 2020 LLC GRAT a promissory note for the value of such interests. The withdrawal of MDM 2014 interests from the Marc Daniel Miller 2020 LLC GRAT resulted in a decrease in the number of shares Alan B. Miller beneficially owns indirectly through the Marc Daniel Miller 2020 LLC GRAT and a corresponding increase in the number of shares Alan B. Miller beneficially owns indirectly through the MDM 2014 LLC. This withdrawal of MDM 2014 LLC interests from the Marc Daniel Miller 2020 LLC GRAT constitutes a change in form of but not the amount of beneficial ownership of the shares. On October 28, 2021, Alan B. Miller withdrew a 35.69034% interest in the MS 2014 LLC (corresponding to 35,690 shares of each of Class A and Class B common stock) from the Marni Spencer 2020 LLC GRAT. In exchange for the MS 2014 LLC interests, Alan B. Miller contributed to the Marni Spencer 2020 LLC GRAT a promissory note for the value of such interests. The withdrawal of MS 2014 interests from the Marni Spencer 2020 LLC GRAT resulted in a decrease in the number of shares Alan B. Miller beneficially owns indirectly through the Marni Spencer 2020 LLC GRAT and a corresponding increase in the number of shares Alan B. Miller beneficially owns indirectly through the MS 2014 LLC. This withdrawal of MS 2014 LLC interests from the Marni Spencer 2020 LLC GRAT constitutes a change in form of but not the amount of beneficial ownership of the shares. Mr. Marc D. Miller disclaims any beneficial interest in the assets of The Marni Spencer 2020 GRAT. On October 28, 2021, Alan B. Miller withdrew a 35.69034% interest in the AMK 2014 LLC (corresponding to 35,690 shares of each of Class A and Class B common stock) from the Abby Miller King 2020 LLC GRAT. In exchange for the AMK 2014 LLC interests, Alan B. Miller contributed to the Abby Miller King 2020 LLC GRAT a promissory note for the value of such interests. The withdrawal of AMK 2014 interests from the Abby Miller King 2020 LLC GRAT resulted in a decrease in the number of shares Alan B. Miller beneficially owns indirectly through the Abby Miller King 2020 LLC GRAT and a corresponding increase in the number of shares Alan B. Miller beneficially owns indirectly through the AMK 2014 LLC. This withdrawal of AMK 2014 LLC interests from the Abby Miller King 2020 LLC GRAT constitutes a change in form of but not the amount of beneficial ownership of the shares. Mr. Marc D. Miller disclaims any beneficial interest in the assets of The Marni Spencer 2020 GRAT. The Class A Common Stock is convertible into Class B Common Stock on a share for share basis. Immediately. Not Applicable. /s/ Steve Filton, Attorney in Fact for Marc D. Miller 2021-10-29