4 1 form4.htm 4 Form 4 – Statement of Changes in Beneficial Ownership – EDGAR Services Provided by St Ives Burrups
FORM 4
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C.  20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP


Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person *

Toll Bruce E.

(Last)        (First)        (Middle)
 2. Issuer Name Assisted Living Concepts, Inc.
     and Ticker or Trading Symbol (ASLC)
 
 
6. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

Director                          10% Owner
 Officer (give title below)  Other (specify below)



3103 Philmont Avenue
3. I.R.S. Identification
    Number of Reporting
    Person, if an entity
    (Voluntary)

 
 
4. Statement for
    Month/Day/Year


2/3/03

(Street)

Huntingdon Valley, PA 19006

5. If Amendment
    Date of Original
    (Month/Day/Year)


7. Individual or Joint/Group
    Filing (Check Applicable Line)

 Form filed by One Reporting Person
 Form filed by More than One 
     Reporting Person
(City)        (State)        (Zip)

Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security
    (Instr. 3)

2.Transaction
   Date
   (Month/Day/
   Year)
2A. Deemed
      Execution
      Date, if any 
      (Month/Day/Year)
3. Transaction
    Code
    (Instr. 8)
4. Securities Acquired (A) or
    Disposed of (D)
    (Instr. 3, 4, and 5)
5. Amount of
    Securities
    Beneficially
    Owned Following
    Reported
    Transaction(s)

    (Instr. 3 and 4)
6. Owner-
    ship
    Form:
    Direct
    (D) or
    Indirect (I)

    (Instr. 4)
7.  Nature of
     Indirect
     Beneficial
     Ownership

     (Instr. 4)
Code
V
Amount
(A) or (D)
Price
Common Stock  2/3/03      1,300  $3.10  939,345  By: BRU Holdings Company Inc., LLC(1) 
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.  
* If the Form is filed by more than one reporting person, see Instruction 4(b)(v). (Over)
     

Form 4
(continued)
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of
    Derivative
    Security
    (Instr. 3)
2. Conver-
    sion or
    Exer-
    cise
    Price of
    Deriva-
    tive
    Security
3. Trans-
    action
    Date

    (Month/
    Day/
    Year)
3A. Deemed
      Execu-
      tion
      Date, 
      if any

      (Month/
      Day/
      Year)
4. Trans-
    action
    Code
    (Instr. 8)
5. Number
    of Deri-
    vative
    Securities
    Acquired
    (A) or
    Disposed
    of (D)

    (Instr. 3, 4
    and 5)
6. Date
    Exercis-
    able
    and
    Expiration
    Date 
    (Month/
    Day/
    Year)
7. Title and
    Amount of
    Underlying
    Securities
    (Instr. 3
    and 4)
 8. Price of
     Deriv-
     ative
     Security
     (Instr. 5)
9. Number
    of Deri-
    vative
    Securi-
    ties
    Benefi-
    cially
    Owned
    Follow-
    ing
    Reported
    Trans-
    action(s)

    (Instr. 4)
10. Owner-
      ship
      Form of
      Deriv-
      ative
      Security:
      Direct
      (D) or
      Indirect
      (I)

      (Instr. 4)
11. Nature of
      Indirect
      Benefi-
      cial
      Owner-
      ship
      (Instr. 4)
Code
V
(A)
(D)
Date
Exercisable
Expira-
tion
Date
   Title   
Amount
or
Number
of
Shares
Explanation of Responses:
(1) The Reporting person is the sole member of BRU Holdings Company, Inc., LLC.
(2) The Reporting Person beneficially owns (i) 340,486 shares of Common Stock in own name, (ii) 492,473 shares held in the name of BET Associates, L.P. (BRU Holdings Company, Inc., LLC (“BRU”) is the sole general partner of BET Associates, L.P. and the Reporting Person is the sole member of BRU), (iii) 3,492 shares held in the name of the Reporting person's daughter, Jennifer Toll, and (iv) 102,894 shares held in the name of BRU.
       
  /s/ Bruce E. Toll   February 6, 2003
 
 
  Bruce E. Toll    
  ** Signature of Reporting Person    
   
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations.
See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
 
Note: File three copies of this Form, one of which must be manually signed. If space provided is insufficient,
see Instruction 6 for procedure.
 

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