-----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, EKtkxNKvbsMYtvFpw/cGFpIKuKEP3Ug11amZf/IYySfdvgKFyIZgER+PwOUCKpLg qek5cHoTdEudmgGm+baT7A== 0001012855-98-000003.txt : 19980206 0001012855-98-000003.hdr.sgml : 19980206 ACCESSION NUMBER: 0001012855-98-000003 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 19980102 FILED AS OF DATE: 19980205 SROS: NYSE SUBJECT COMPANY: 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 FILING VALUES: FORM TYPE: 3 SEC ACT: SEC FILE NUMBER: 001-10822 FILM NUMBER: 98521945 BUSINESS ADDRESS: STREET 1: 100 VINE ST STE 1402 CITY: MURFREESBORO STATE: TN ZIP: 37130 BUSINESS PHONE: 6158909100 MAIL ADDRESS: STREET 1: P.O. BOX 1102 CITY: MURFREESBORO STATE: TN ZIP: 37133 COMPANY DATA: COMPANY CONFORMED NAME: ADAMS ROBERT G CENTRAL INDEX KEY: 0001012855 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-SKILLED NURSING CARE FACILITIES [8051] OFFICER STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 BUSINESS ADDRESS: STREET 1: P.O. BOX 1398 CITY: MURFREESBORO STATE: TN ZIP: 37133-1398 BUSINESS PHONE: 6158902020 MAIL ADDRESS: STREET 1: P.O. BOX 1398 CITY: MURFREESBORO STATE: TN ZIP: 37133-1398 3 1 FORM 3 - JANUARY 2, 1998 UNITED STATES SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 FORM 3 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES 1. Name and Address of Reporting Person Adams, Robert G. 2217 Tomahawk Trace Murfreesboro, TN 37129 2. Date of Event Requiring Statement (Month/Day/Year) January 2, 1998 3. IRS or Social Security Number of Reporting Person (Voluntary) ###-##-#### 4. Issuer Name and Ticker or Trading Symbol National Health Investors, Inc. NHI 5. Relationship of Reporting Person(s) to Issuer (Check all applicable) ( ) Director ( ) 10% Owner (X) Officer (give title below) ( ) Other (specify below) Vice President 6. If Amendment, Date of Original (Month/Day/Year) 7. Individual or Joint/Group Filing (Check Applicable Line) (X) Form filed by One Reporting Person ( ) Form filed by More than One Reporting Person
___________________________________________________________________________________________________________________________________ Table I -- Non-Derivative Securities Beneficially Owned | ___________________________________________________________________________________________________________________________________| 1. Title of Security |2. Amount of |3. Ownership |4. Nature of Indirect | | Securities | Form: | Beneficial Ownership | | Beneficially | Direct(D) or | | | Owned | Indirect(I) | | ___________________________________________________________________________________________________________________________________| Common Stock |206,300 |D | | - -----------------------------------------------------------------------------------------------------------------------------------| Common Stock |29,000 |I |Family Partnership | - -----------------------------------------------------------------------------------------------------------------------------------| ___________________________________________________________________________________________________________________________________| ___________________________________________________________________________________________________________________________________ Table II -- Derivative Securitites Beneficially Owned | ___________________________________________________________________________________________________________________________________| 1.Title of Derivative |2.Date Exer- |3.Title and Amount | |4. Conver-|5. Owner- |6. Nature of Indirect | Security | cisable and | of Underlying | |sion or |ship | Beneficial Ownership | | Expiration | Securities | |exercise |Form of | | | Date(Month/ |-----------------------|---------|price of |Deriv- | | | Day/Year) | |Amount |deri- |ative | | | Date | Expira- | |or |vative |Security: | | | Exer- | tion | Title |Number of|Security |Direct(D) or | | | cisable | Date | |Shares | |Indirect(I) | | ___________________________________________________________________________________________________________________________________| Option to purchase commo|3/4/93 |3/3/98 |Common Stock |4,000 |$25.00 |D | | n stock | | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| Option to purchase commo|1/15/97 |1/14/2002|Common Stock |30,000 |$36.00 |D | | n stock | | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| ___________________________________________________________________________________________________________________________________|
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