-----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, MebZylUeMvIJojQVqwVs3np7rCerJfBUsEk07LjeRbd6RMssfP9uBYCWtyvdr1yR NmZhxoBiA3PgvBCc9IwHCg== 0001131676-04-000001.txt : 20040406 0001131676-04-000001.hdr.sgml : 20040406 20040406110951 ACCESSION NUMBER: 0001131676-04-000001 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040402 FILED AS OF DATE: 20040406 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: PSYCHIATRIC SOLUTIONS INC CENTRAL INDEX KEY: 0000829608 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-SPECIALTY OUTPATIENT FACILITIES, NEC [8093] IRS NUMBER: 232491707 STATE OF INCORPORATION: DE FISCAL YEAR END: 0430 BUSINESS ADDRESS: STREET 1: 113 SEABOARD LANE STREET 2: SUITE C-100 CITY: FRANKLIN STATE: TN ZIP: 37067 BUSINESS PHONE: 615-312-5700 MAIL ADDRESS: STREET 1: 113 SEABOARD LANE STREET 2: SUITE C-100 CITY: FRANKLIN STATE: TN ZIP: 37067 FORMER COMPANY: FORMER CONFORMED NAME: PMR CORP DATE OF NAME CHANGE: 19920703 FORMER COMPANY: FORMER CONFORMED NAME: ZARON CAPITAL INC DATE OF NAME CHANGE: 19891116 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: OAK INVESTMENT PARTNERS X LTD PARTNERSHIP CENTRAL INDEX KEY: 0001131676 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-20488 FILM NUMBER: 04719485 BUSINESS ADDRESS: STREET 1: ONEGORHAM ISLAND CITY: WESTPORT STATE: CT ZIP: 06880 BUSINESS PHONE: 2032268346 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: OAK INVESTMENT PARTNERS VI LP CENTRAL INDEX KEY: 0000933938 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-20488 FILM NUMBER: 04719486 BUSINESS ADDRESS: STREET 1: ONE GORHAM ISLAND CITY: WESTPORT STATE: CT ZIP: 06880 BUSINESS PHONE: 2032268346 MAIL ADDRESS: STREET 1: ONE GORHAM ISLAND CITY: WESTPORT STATE: CT ZIP: 06880 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: LAMONT ANN H CENTRAL INDEX KEY: 0001199270 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-20488 FILM NUMBER: 04719487 BUSINESS ADDRESS: STREET 1: ONE GORHAM ISLAND CITY: WESTPORT STATE: CT ZIP: 06880 BUSINESS PHONE: 2032268346 MAIL ADDRESS: STREET 1: ONE GORHAM ISLAND CITY: WESTPORT STATE: CT ZIP: 06880 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: OAK X AFFILIATES FUND LP CENTRAL INDEX KEY: 0001143824 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-20488 FILM NUMBER: 04719488 BUSINESS ADDRESS: STREET 1: ONE GORHAM ISLAND CITY: WESTPORT STATE: CT ZIP: 06880 BUSINESS PHONE: 2032268346 MAIL ADDRESS: STREET 1: ONE GORHAM ISLAND CITY: WESTPORT STATE: CT ZIP: 06880 4 1 edgar.xml PRIMARY DOCUMENT X0201 4 2004-04-02 0000829608 PSYCHIATRIC SOLUTIONS INC PSYS 0001199270 LAMONT ANN H C/O OAK INVESTMENT PARTNERS ONE GORHAM ISLAND WESTPORT CT 06880 1 0 1 0 0000933938 OAK INVESTMENT PARTNERS VI LP ONE GORHAM ISLAND WESTPORT CT 06880 0 0 1 0 0001131676 OAK INVESTMENT PARTNERS X LTD PARTNERSHIP ONE GORHAM ISLAND WESTPORT CT 06880 0 0 1 0 0001143824 OAK X AFFILIATES FUND LP ONE GORHAM ISLAND WESTPORT CT 06880 0 0 1 0 Common Stock 2004-04-02 4 C 0 1192970 A 1247064 I See Note Common Stock 2004-04-02 4 C 0 19151 A 20019 I See Note Common Stock 2004-04-02 4 J 0 1247064 D 0 I See Note Common Stock 2004-04-02 4 J 0 20019 D 0 I See Note Common Stock 473 I See Note Series A Preferred Stock 2004-04-02 4 C 0 1192970 D Common Stock 1192970 2385940 I See Note Series A Preferred Stock 2004-04-02 4 C 0 19151 D Common Stock 19151 38303 I See Note Represents the number of shares of Common Stock issued to such Reporting Person upon the conversion of shares of Series A Preferred Stock as reported in Table II. The conversion price of the Series A Preferred Stock was approximately $5.50 per share. Includes 54,094 shares of Common Stock received pursuant to a paid-in-kind dividend that had accrued on the shares of Series A Preferred Stock that were converted on April 2, 2004 and such dividend was paid upon such conversion. Represents shares directly owned by Oak Investment Partners X, Limited Partnership ("Oak X, L.P."). Includes 868 shares of Common Stock received pursuant to a paid-in-kind dividend that had accrued on the shares of Series A Preferred Stock that were converted on April 2, 2004 and such dividend was paid upon such conversion. Represents shares directly owned by Oak X Affiliates Fund, Limited Partnership ("Oak X Affiliates, L.P."). On April 2, 2004, Oak X, L.P. made an in-kind distribution, without any additional consideration, of Common Stock to the limited partners of Oak X, L.P. On April 2, 2004, Oak X Affiliates, L.P. made an in-kind distribution, without any additional consideration, of Common Stock to the limited partners of Oak X Affiliates, L.P. Represents shares directly owned by Oak Investment Partners VI, Limited Partnership ("Oak VI, L.P."). Each share of Series A Preferred Stock is initially convertible into 1 share of Common Stock at a conversion price of $5.50 per share. The conversion price remains subject to adjustment pursuant to the terms of the Series A Preferred Stock. The Series A Preferred Stock is immediately convertible. The conversion feature continues indefinitely. As the transaction involves the conversion of a derivative security, no information is required to be included in Column 8 of Table II, in accordance with general instruction 4(c)(iii). Such shares of Series A Preferred Stock have accrued pay-in-kind dividends equal to 108,187 shares of Common Stock as of April 2, 2004, which dividends are payable upon conversion of such shares of Series A Preferred Stock. Such shares of Series A Preferred Stock have accrued pay-in-kind dividends equal to 1,737 shares of Common Stock as of April 2, 2004, which dividends are payable upon conversion of such shares of Series A Preferred Stock. Remarks Ann H. Lamont is a Director of Psychiatric Solutions, Inc. Ms. Lamont is a Managing Member of Oak Associates VI, L.L.C., the General Partner of Oak VI, L.P.; a Managing Member of Oak Associates X, L.L.C., the General Partner of Oak X, L.P.; and a Managing Member of Oak X Affiliates, L.L.C., the General Partner of Oak X Affiliates, L.P. Each Reporting Person disclaims the existence of a "group" and disclaims beneficial ownership of any securities (except to the extent of such Reporting Person's pecuniary interest in such securities) other than any securities reported herein as being directly owned by such Reporting Person, and this report shall not be deemed an admission that such Reporting Person is the beneficial owner of any such securities for purposes of Section 16 or for any other purpose. Ann H. Lamont 2004-04-06 Ann H. Lamont, Managing Member of Oak Associates VI, L.L.C., the General Partner of Oak Investment Partners VI, Limited Partnership 2004-04-06 Ann H. Lamont, Managing Member of Oak Associates X, L.L.C., the General Partner of Oak Investment Partners X, Limited Partnership 2004-04-06 Ann H. Lamont, Managing Member of Oak X Affiliates, L.L.C., the General Partner of Oak X Affiliates Fund, Limited Partnership 2004-04-06 -----END PRIVACY-ENHANCED MESSAGE-----