-----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, WpwEDdZRJXLYCL58ghoPkqsgTcOp/efYosg5E+sIFoCHzZddybEeDDVNuARxSlZO cN1Bm2kxMrgbHB9+7SpW5A== 0001005477-03-001151.txt : 20030515 0001005477-03-001151.hdr.sgml : 20030515 20030515175358 ACCESSION NUMBER: 0001005477-03-001151 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20030513 FILED AS OF DATE: 20030515 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: UCI MEDICAL AFFILIATES INC CENTRAL INDEX KEY: 0000737561 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-SPECIALTY OUTPATIENT FACILITIES, NEC [8093] IRS NUMBER: 592225346 STATE OF INCORPORATION: DE FISCAL YEAR END: 0930 BUSINESS ADDRESS: STREET 1: 1901 MAIN ST MAIL CODE 1105 STREET 2: STE 1200 CITY: COLUMBIA STATE: SC ZIP: 29201 BUSINESS PHONE: 8032523661 MAIL ADDRESS: STREET 1: 1901 MAIN ST MAIL CODE 1105 STREET 2: SUITE 1200 CITY: COLUMBIA STATE: SC ZIP: 29201 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: COMPANION HEALTHCARE CORP CENTRAL INDEX KEY: 0001003235 STATE OF INCORPORATION: SC FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-13265 FILM NUMBER: 03706719 BUSINESS ADDRESS: STREET 1: I-20 AT ALPINE ROAD CITY: COLUMBIA STATE: SC ZIP: 29219 BUSINESS PHONE: 8037880222 MAIL ADDRESS: STREET 1: I-20 AT ALPINE ROAD CITY: COLUMBIA STATE: SC ZIP: 29219 4 1 edgar123.xml FORM 4 X0101 4 2003-05-13 0 0000737561 UCI MEDICAL AFFILIATES INC ucia 0001003235 COMPANION HEALTHCARE CORP 0 0 1 0 Common Stock 2003-05-13 4 P 0 2020387 808154.80 A 4645010 I See footnote Pursuant to Form 4 General Instruction 4(b)(v), this Form 4 is being filed jointly by Companion HealthCare Corporation ("CHC") which holds direct ownership of 4,026,829 shares; by Companion Property and Casualty Insurance Company ("CPIC") which holds direct ownership of 618,181 shares; and by Blue Cross and Blue Shield of South Carolina ("BCBS") which does not hold direct ownership of any shares, but which may be deemed to beneficially own the shares held by CHC and CPIC, each of which is a wholly owned subsidiary of BCBS. All three of these entities have the same address. Robert A. Leichtle is authorized as an officer of all three entities to sign this Form 4 on behalf of each of the three entities. His execution of this Form 4 is made by him in his capacity as Treasurer of each of the three entities. by: /s/ Robert A. Leichtle 2003-05-13 -----END PRIVACY-ENHANCED MESSAGE-----