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