-----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, Sa91pO7ovH1LJz2GJAN/pdJGQlodF7ufRqNE1zyfVqN572Fx84Rvdi/BGC02fIwD +z+rfeDQliME2J8ohy+34w== 0001209191-09-014290.txt : 20090306 0001209191-09-014290.hdr.sgml : 20090306 20090306105917 ACCESSION NUMBER: 0001209191-09-014290 CONFORMED SUBMISSION TYPE: 5/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20081231 FILED AS OF DATE: 20090306 DATE AS OF CHANGE: 20090306 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/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-10822 FILM NUMBER: 09661063 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/A 1 doc5a.xml FORM 5/A SUBMISSION X0303 5/A 2008-12-31 2009-02-17 0 0 1 0000877860 NATIONAL HEALTH INVESTORS INC NHI 0001012853 ADAMS W ANDREW 750 S. CHURCH STREET SUITE B MURFREESBORO TN 37130 1 1 0 0 President Common Stock by Amk, L.P. 2008-12-23 5 J 0 311615 0.00 A 858036 D Common Stock By Children & Trust Grandchildren's Trust 2008-12-23 4 J 0 59955 0.00 A 69705 I Trustee Common Stock By EMA, L.P. 2008-12-18 5 G 0 338552 0.00 A 338552 D Common Stock By Adams Family Foundation II 222307 I Trustee Common Stock By Springland Ventures, L.P. 44000 D Shares distributed by The Adams Group L.P. pursuant to a Marital Dissolution Agreement. Reporting person no longer has a reportable position in The Adams Group L.P. as a result of the Marital Dissolution Agreement. /s/ W. Andrew Adams 2009-03-06 -----END PRIVACY-ENHANCED MESSAGE-----