FORM 4 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). |
1. Name and Address of Reporting Person*
(Street)
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2. Issuer Name and Ticker or Trading Symbol
PSYCHIATRIC SOLUTIONS INC [ PSYS ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Date of Earliest Transaction
(Month/Day/Year) 09/22/2003 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed
(Month/Day/Year) |
6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | ||||||||||
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1. Title of Security (Instr. 3) | 2. Transaction Date (Month/Day/Year) | 2A. Deemed Execution Date, if any (Month/Day/Year) | 3. Transaction Code (Instr. 8) | 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) | 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) | 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 7. Nature of Indirect Beneficial Ownership (Instr. 4) | |||
Code | V | Amount | (A) or (D) | Price | ||||||
Common Stock(2) | 09/22/2003 | J(1) | 11,485 | D | $0(1) | 22,969 | D | |||
Common Stock(4) | 09/22/2003 | J(3) | 6,473 | D | $0(3) | 12,943 | D | |||
Common Stock(6) | 09/22/2003 | J(5) | 23,442 | D | $0(5) | 46,919 | D | |||
Common Stock(7) | 4,956 | D | ||||||||
Common Stock(8) | 4,959 | D |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
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1. Title of Derivative Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) | 6. Date Exercisable and Expiration Date (Month/Day/Year) | 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) | 8. Price of Derivative Security (Instr. 5) | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) | ||||
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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Explanation of Responses: |
1. On 9/22/03, CGJR II, L.P. ("CGJR II") made an in-kind pro rata distribution of shares of Common Stock to its general and limited partners. |
2. The securities are owned directly by CGJR II. CGJR Capital Management, Inc. ("CGJR Management") may be deemed to indirectly own the securities. CGJR Management disclaims beneficial ownership of the securities (except to the extent of CGJR Management's pecuniary interest in such securities), and this report shall not be deemed an admission that CGJR Management is the beneficial owner of any such securities for purposes of Section 16 or for any other purpose. |
3. On 9/22/03, CGJR/MF III, L.P. ("CGJR III") made an in-kind pro rata distribution of shares of Common Stock to its general and limited partners. |
4. The securities are owned directly by CGJR III. CGJR Management may be deemed to indirectly own the securities. CGJR Management disclaims beneficial ownership of the securities (except to the extent of CGJR Management's pecuniary interest in such securities), and this report shall not be deemed an admission that CGJR Management is the beneficial owner of any such securities for purposes of Section 16 or for any other purpose. |
5. On 9/22/03, CGJR Health Care Services Private Equities, L.P. ("CGJR Health") made an in-kind pro rata distribution of shares of Common Stock to its general and limited partners. |
6. The securities are owned directly by CGJR Health. CGJR Management may be deemed to indirectly own the securities. CGJR Management disclaims beneficial ownership of the securities (except to the extent of CGJR Management's pecuniary interest in such securities), and this report shall not be deemed an admission that CGJR Management is the beneficial owner of any such securities for purposes of Section 16 or for any other purpose. |
7. The securities are owned directly by CGJR Management and 1,652 shares of such total shares were received as part of the distributions described in notes (1), (3) and (5). Christopher Grant, Jr. may be deemed to indirectly own the securities. In prior reports, CGJR Management and Christopher Grant, Jr. each reported indirect beneficial ownership of such shares. |
8. The securities are owned directly by Christopher Grant, Jr. and 1,653 shares of such total shares were received as part of the distribution described in note (5). In prior reports, CGJR Management and Christopher Grant, Jr. each reported indirect beneficial ownership of such shares. |
Remarks: |
Christopher Grant, Jr., a director of the Issuer, is the president of CGJR Management. CGJR Management is the general partner of each of CGJR II , CGJR III, and CGJR Health. Mr. Grant is also the president of Salix Management Corp. ("Salix Management"), a general partner of Salix Partners II ("Salix Partners") and a manager of each of Salix Donovan, LLC ("Salix Donovan"), Salix Ivy, LLC ("Salix Ivy"), Salix Pou, LLC ("Salix Pou"). Salix Partners is the general partner of each of Salix Ventures II, L.P. ("Salix Ventures") and Salix Affiliates II, L.P. ("Salix Affiliates"). A separate report on Form 4 is being filed on the date hereof by Salix Management, Salix Partners, Salix Donovan, Salix Ivy, Salix Pou, Salix Ventures, Salix Affiliates, David Ward and Martin R. Felsenthal. 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. |
Robert D. Ivy, as attorney-in-fact for Christopher Grant, Jr. | 09/24/2003 | |
Robert D. Ivy, as attorney-in-fact for CGJR/MF III, L.P. | 09/24/2003 | |
Robert D. Ivy, as attorney-in-fact for CGJR Capital Management, Inc. | 09/24/2003 | |
Robert D. Ivy, as attorney-in-fact for CGJR Health Care Services Private Equities, L.P. | 09/24/2003 | |
Robert D. Ivy, as attorney-in-fact for CGJR II, L.P. | 09/24/2003 | |
** Signature of Reporting Person | Date | |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v). | ||
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). | ||
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |