0001209191-12-006454.txt : 20120131
0001209191-12-006454.hdr.sgml : 20120131
20120131182453
ACCESSION NUMBER: 0001209191-12-006454
CONFORMED SUBMISSION TYPE: 5
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20111231
FILED AS OF DATE: 20120131
DATE AS OF CHANGE: 20120131
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Eastridge Kevin Delon
CENTRAL INDEX KEY: 0001441036
FILING VALUES:
FORM TYPE: 5
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-22217
FILM NUMBER: 12560496
MAIL ADDRESS:
STREET 1: AMSURG
STREET 2: 20 BURTON HILLS BOULEVARD
CITY: NASHVILLE
STATE: TN
ZIP: 37215
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
X0304
5
2011-12-31
0
0
0
0000895930
AMSURG CORP
AMSG
0001441036
Eastridge Kevin Delon
20 BURTON HILLS BLVD.
SUITE 500
NASHVILLE
TN
37215
0
1
0
0
Sr. VP of Finance, CAO
Common stock
36024
D
Employee stock option
24.10
2004-01-28
2014-01-28
Common stock
15000
15000
D
Employee stock option
25.76
2005-01-27
2015-01-27
Common stock
25000
25000
D
Employee stock option
21.07
2006-02-17
2016-02-17
Common stock
20000
20000
D
Employee stock option
22.84
2011-02-15
2017-02-15
Common stock
7377
7377
D
Employee stock option
24.75
2012-02-21
2018-02-21
Common stock
7819
7819
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/ Kevin D. Eastridge
2012-01-31