-----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, SoYBydNPlmPscrY298dcoYLpblqjkzvE08bUrqaceKCYRmwpV1BaLe020Frjyti1 C+uGFfBKWntbVsrkPUL30g== 0001127602-09-003961.txt : 20090217 0001127602-09-003961.hdr.sgml : 20090216 20090217182935 ACCESSION NUMBER: 0001127602-09-003961 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20081231 FILED AS OF DATE: 20090217 DATE AS OF CHANGE: 20090217 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: 09616442 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: 750-B SOUTH CHURCH STREET 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 form5.xml PRIMARY DOCUMENT X0303 5 2008-12-31 0 0 0000877860 NATIONAL HEALTH INVESTORS INC NHI 0001012853 ADAMS W ANDREW 750 S. CHURCH STREET SUITE B MURFREESBORO TN 37130 1 1 President Common Stock by EMA, L.P. 2008-12-18 5 G 0 338552 26.00 A 338552 D Common Stock By Adams Family Foundation 222307 I Trustee Common Stock By Springland Ventures, L.p. 44000 D Common Stock By Amk, L.p. 858036 D Common Stock By Children & Grandchildren's Trust 69705 I Trustee Common Stock By The Adams Group L.p. 1564467 I None due to MDA Children's Trust and Charitable Lead Annuity Trust /s/W. Andrew Adams 2009-02-17 -----END PRIVACY-ENHANCED MESSAGE-----