0001209191-11-060068.txt : 20111207 0001209191-11-060068.hdr.sgml : 20111207 20111207171245 ACCESSION NUMBER: 0001209191-11-060068 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20111207 FILED AS OF DATE: 20111207 DATE AS OF CHANGE: 20111207 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: WAHL Theodore CENTRAL INDEX KEY: 0001454244 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-12015 FILM NUMBER: 111249255 MAIL ADDRESS: STREET 1: 3220 TILLMAN DRIVE STREET 2: SUITE 300 CITY: BENSALEM STATE: PA ZIP: 19020 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: HEALTHCARE SERVICES GROUP INC CENTRAL INDEX KEY: 0000731012 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-TO DWELLINGS & OTHER BUILDINGS [7340] IRS NUMBER: 232018365 STATE OF INCORPORATION: PA FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 2643 HUNTINGDON PIKE CITY: HUNTINGDON VALLEY STATE: PA ZIP: 19006 BUSINESS PHONE: 2159381661 MAIL ADDRESS: STREET 1: 2643 HUNTINGDON PIKEE CITY: HUNTINGDON VALLEY STATE: PA ZIP: 19006 4 1 doc4.xml FORM 4 SUBMISSION X0304 4 2011-12-07 0 0000731012 HEALTHCARE SERVICES GROUP INC HCSG 0001454244 WAHL Theodore 3220 TILLMAN DRIVE SUITE 300 BENSALEM PA 19020 1 1 0 0 Chief Operating Officer Common stock 2011-12-07 4 G 0 59880 0.00 A 68152 D Common stock 2011-12-07 4 G 0 1405 0.00 A 71855 I Held by spouse Common stock 2011-12-07 4 G 0 4845 0.00 A 15001 I Held by minor children /s/ Theodore Wahl 2011-12-07