-----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, A5SZXjT8QgSveScOGCgAZkQJsTyjUMaXfkNqGAPtJ1+p5YInzIa1oV73NqVh/Y+g nVD7RWF8zkx28YYqnN7TSw== 0000860730-04-000042.txt : 20040202 0000860730-04-000042.hdr.sgml : 20040202 20040202183441 ACCESSION NUMBER: 0000860730-04-000042 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040129 FILED AS OF DATE: 20040202 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: HAZEN SAMUEL N CENTRAL INDEX KEY: 0001216838 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-11239 FILM NUMBER: 04560473 MAIL ADDRESS: STREET 1: ONE PARK PLAZA CITY: NASHVILLE STATE: TN ZIP: 37203 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: HCA INC/TN CENTRAL INDEX KEY: 0000860730 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-GENERAL MEDICAL & SURGICAL HOSPITALS, NEC [8062] IRS NUMBER: 752497104 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: ONE PARK PLZ CITY: NASHVILLE STATE: TN ZIP: 37203 BUSINESS PHONE: 6153449551 MAIL ADDRESS: STREET 1: ONE PARK PLAZA CITY: NASHVILLE STATE: TN ZIP: 37203 FORMER COMPANY: FORMER CONFORMED NAME: HCA THE HEALTHCARE CO DATE OF NAME CHANGE: 20010419 FORMER COMPANY: FORMER CONFORMED NAME: COLUMBIA HCA HEALTHCARE CORP DATE OF NAME CHANGE: 20000502 FORMER COMPANY: FORMER CONFORMED NAME: COLUMBIA HCA HEALTHCARE CORP/ DATE OF NAME CHANGE: 19940314 4 1 haz609.xml X0201 4 2004-01-29 0 0000860730 HCA INC/TN (HCA) 0001216838 HAZEN SAMUEL N ONE PARK PLAZA NASHVILLE TN 37203 0 1 0 0 President-Western Group Common Stock 2004-01-29 4 F 0 1657 45.8600 D 51552 D Common Stock 1886 I By 401(k) Non-Qualified Stock Option (right to buy) 45.8600 2004-01-29 4 A 0 125000 0 A 2014-01-29 Common Stock 125000 125000 D Right to buy pursuant to the HCA 2000 Equity Incentive Plan which includes tax withholding rights. The options vest in four equal annual installments beginning on 1/29/2005. By: /s/ Dora A. Blackwood, Attorney-in-Fact 2004-01-30 -----END PRIVACY-ENHANCED MESSAGE-----