-----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, KfGdak3UbGxLZvOotyBr5qpBCgQjG06aMjh9qcqC71U4E+W23RHXvQE2cccTrN3r RJ6555N3MuHuR1JNKMgrnA== 0001209191-11-005569.txt : 20110128 0001209191-11-005569.hdr.sgml : 20110128 20110128164800 ACCESSION NUMBER: 0001209191-11-005569 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20101231 FILED AS OF DATE: 20110128 DATE AS OF CHANGE: 20110128 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: GULMI CLAIRE M CENTRAL INDEX KEY: 0001200152 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-22217 FILM NUMBER: 11556429 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: SUITE 500 CITY: NASHVILLE STATE: TN ZIP: 37215 BUSINESS PHONE: 615-665-1283 MAIL ADDRESS: STREET 1: 20 BURTON HILLS BLVD. STREET 2: SUITE 500 CITY: NASHVILLE STATE: TN ZIP: 37215 5 1 doc5.xml FORM 5 SUBMISSION X0303 5 2010-12-31 0 0 0 0000895930 AMSURG CORP AMSG 0001200152 GULMI CLAIRE M 20 BURTON HILLS BLVD. SUITE 500 NASHVILLE TN 37215 1 1 0 0 Executive VP & CFO Common stock 56256 D Employee stock option 14.667 2001-11-15 2011-11-15 Common stock 60000 60000 D Employee stock option 16.20 2002-01-24 2012-01-24 Common stock 30000 30000 D Employee stock option 14.78 2003-02-06 2013-02-06 Common stock 81000 81000 D Employee stock option 24.10 2004-01-28 2014-01-28 Common stock 75000 75000 D Employee stock option 25.76 2005-01-27 2015-01-27 Common stock 45000 45000 D Employee stock option 21.07 2006-02-17 2016-02-17 Common stock 70000 70000 D Employee stock option 22.84 2011-02-15 2017-02-15 Common stock 48380 48380 D Employee stock option 24.75 2012-02-21 2018-02-21 Common stock 24008 24008 D Options are to purchase shares of common stock and vest in equal installments over 4 years, starting on the Date Exercisable. Options are to purchase shares of common stock and vest 4 years from transaction date. /s/ Claire M. Gulmi 2011-01-28 -----END PRIVACY-ENHANCED MESSAGE-----