-----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, SqzV0CR9Wdo+ZQxsDOGwftIm7m+ClSzct60OJHaVF35L9Mu9Ny8zhtgtP3Fwduah ovAq5Eom4qBc+sS/JPgDSA== 0001209191-04-009579.txt : 20040213 0001209191-04-009579.hdr.sgml : 20040213 20040213115105 ACCESSION NUMBER: 0001209191-04-009579 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20031231 FILED AS OF DATE: 20040213 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: AMSURG CORP CENTRAL INDEX KEY: 0000895930 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-OFFICES & CLINICS OF DOCTORS OF MEDICINE [8011] IRS NUMBER: 621493316 STATE OF INCORPORATION: TN FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 20 BURTON HILLS BLVD STREET 2: STE 350 CITY: NASHVILLE STATE: TN ZIP: 37215 BUSINESS PHONE: 6156651283 MAIL ADDRESS: STREET 1: ONE BURTON HILLS BLVD. STREET 2: SUITE 350 CITY: NASHVILLE STATE: TN ZIP: 37215 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: HARRELL ROYCE D CENTRAL INDEX KEY: 0001200153 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-22217 FILM NUMBER: 04596072 BUSINESS ADDRESS: STREET 1: AMSURG CORP STREET 2: 20 BURTON HILLS BLVD. CITY: NASHVILLE STATE: TN ZIP: 37215 5 1 doc5.xml FORM 5 SUBMISSION X0201 5 2003-12-31 0 0 0 0000895930 AMSURG CORP AMSG 0001200153 HARRELL ROYCE D 20 BURTON HILLS BLVD. SUITE 500 NASHVILLE TN 37215 0 1 0 0 Sr. VP - Corporate Services Employee stock option 4.6800 1997-01-08 2006-01-08 Common stock 8333.0000 8333.0000 D Employee stock option 5.9100 1998-02-07 2007-02-07 Common stock 8333.0000 8333.0000 D Employee stock option 9.1300 1999-02-23 2008-02-23 Common stock 5000.0000 5000.0000 D Employee stock option 7.6250 1999-01-21 2009-01-21 Common stock 9000.0000 9000.0000 D Employee stock option 6.7500 2000-01-27 2010-01-27 Common stock 10000.0000 10000.0000 D Employee stock option 24.8750 2001-02-01 2011-02-01 Common stock 8000.0000 8000.0000 D Employee stock option 22.0000 2001-11-15 2011-11-15 Common stock 20000.0000 20000.0000 D Employee stock option 24.3000 2002-01-24 2012-01-24 Common stock 15000.0000 15000.0000 D Employee stock option 22.1700 2003-02-06 2013-02-06 Common stock 28000.0000 28000.0000 D Options are to purchase shares of common stock and vest in equal installments beginning on Date Exercisable. /s/ Royce D. Harrell 2004-02-13 -----END PRIVACY-ENHANCED MESSAGE-----