-----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, O/53ed2ighNOef0Ascw1sszB+Kes6t88ZD/vw2vF3vuH/diljXV/iQaSmv3PGqUf dBL7A/MjPGEQGVaUqRA39Q== 0000877860-05-000008.txt : 20050112 0000877860-05-000008.hdr.sgml : 20050112 20050112143743 ACCESSION NUMBER: 0000877860-05-000008 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20041231 FILED AS OF DATE: 20050112 DATE AS OF CHANGE: 20050112 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ADAMS W ANDREW CENTRAL INDEX KEY: 0001012853 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-SKILLED NURSING CARE FACILITIES [8051] STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-10822 FILM NUMBER: 05525619 BUSINESS ADDRESS: BUSINESS PHONE: 6158902020 MAIL ADDRESS: STREET 1: P.O. BOX 1398 CITY: MURFREESBORO STATE: TN ZIP: 37133-1398 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: NATIONAL HEALTH INVESTORS INC CENTRAL INDEX KEY: 0000877860 STANDARD INDUSTRIAL CLASSIFICATION: REAL ESTATE INVESTMENT TRUSTS [6798] IRS NUMBER: 621470956 STATE OF INCORPORATION: MD FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 100 VINE ST STE 1400 STREET 2: CITY CENTER CITY: MURFREESBORO STATE: TN ZIP: 37130 BUSINESS PHONE: 6158909100 MAIL ADDRESS: STREET 1: P.O. BOX 1102 CITY: MURFREESBORO STATE: TN ZIP: 37133-1102 5 1 edgar.xml PRIMARY DOCUMENT X0202 5 2004-12-31 0 0 0000877860 NATIONAL HEALTH INVESTORS INC NHI 0001012853 ADAMS W ANDREW 100 VINE ST., SUITE 1400 MURFREESBORO TN 37130 1 1 0 0 CEO Common Stock by Adams Family Foundation II 222307 I Trustee Common Stock by Springland Ventures, L.P. 44000 D Common Stock by Adams Investments L.P. 71994 I Partnership Common Stock by The Adams Group, L.P. 1864043 D Common Stock by AMK, L.P. 454117 D Common Stock by Children & Grandchildren's Trust 9750 I Trustee Employee Stock Option - Right to Buy 14.50 1999-10-26 2005-10-25 Common Stock 23104 23104 D W. Andrew Adams 2005-01-12 -----END PRIVACY-ENHANCED MESSAGE-----