-----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, OORjB54J693IGhBc3Ye23CEHn9G09bb6TWDkmBSdjy38Ls4xIOwGiFvUhwbBWPn/ qN/AELcFxDPsLJ2G+LrOmA== 0001011723-02-000150.txt : 20020912 0001011723-02-000150.hdr.sgml : 20020912 20020912154936 ACCESSION NUMBER: 0001011723-02-000150 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20020815 FILED AS OF DATE: 20020912 REPORTING-OWNER: COMPANY DATA: COMPANY CONFORMED NAME: MACKENZIE PATTERSON INC CENTRAL INDEX KEY: 0001102946 STANDARD INDUSTRIAL CLASSIFICATION: UNKNOWN SIC - 0000 [0000] RELATIONSHIP: OWNER IRS NUMBER: 680151215 STATE OF INCORPORATION: CA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 BUSINESS ADDRESS: STREET 1: 1640 SCHOOL STREET SUITE 100 CITY: MORAGOS STATE: CA ZIP: 94556 BUSINESS PHONE: 9256319100 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: ASSISTED LIVING CONCEPTS INC CENTRAL INDEX KEY: 0000929994 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-NURSING & PERSONAL CARE FACILITIES [8050] IRS NUMBER: 931148702 STATE OF INCORPORATION: NV FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-13498 FILM NUMBER: 02762617 BUSINESS ADDRESS: STREET 1: 11835 NE GLENN WIDING DRIVE STREET 2: BLDG E CITY: PORTLAND STATE: OR ZIP: 97220-9057 BUSINESS PHONE: 5032526233 MAIL ADDRESS: STREET 1: 11835 NE GLENN WIDING DRIVE STREET 2: BLDG E CITY: PORTLAND STATE: OR ZIP: 97220-9057 3 1 mpialcform3.txt INITIAL FILING
UNITED STATES SECURITIES AND EXCHANGE COMMISSION FORM 3 Washington, D. C. 20549 OMB Number: 3235-0104 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES 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(f) of the Investment Company Act of 1940 (Print or Type Responses) - ----------------------------------------------------------------------------------------------------------------------------------- | | | | |1. Name and Address of Reporting Person * |2. Date of Event |4. Issuer Name and Ticker or Trading Symbol | | | Requiring Statement | Assisted Living Concepts, Inc. (ASLC) | | MP Acquisition Co., LLC | (Month/Day/Year) |----------------------------------------------------------| |---------------------------------------------| |5. Relationship of Reporting |6. If Amendment, | | (Last) (First) (Middle)| 8/15/02 | Person(s) to Issuer |Date of Original | | | | (Check all applicable) |(Month/Day/Year) | | 1640 School Street, Suite 100 |-------------------------| | | |---------------------------------------------| |[ ] Director [X] 10% Owner | | | (Street) |3. I.R.S. Identification |[ ] Officer [ ] Other |----------------------------| | | Number of Reporting | (give (specify |7. Individual or | | Moraga California 94556 | Person, if an entity | title below) | Joint/Group Filing | |---------------------------------------------| (voluntary) | below) |(check applicable line) | | (City) (State) (Zip) | | |[ ] Form Filed By One | | | | | Reporting Person | | | | |[X] Form Filed By More | | | | | than one Reporting Person| - -----------------------------------------------------------------------------------------------------------------------------------| | | | | | Table I - Non-Derivative Securities Beneficially Owned | - -----------------------------------------------------------------------------------------------------------------------------------| |1. Title of Security |2. Amount of Securities |3. Ownership |4. Nature of Indirect Beneficial | | (Instr. 4) | Beneficially Owned | Form: Direct | Ownership | | | (Instr. 4) | (D) or Indirect | (Instr. 5) | | | | (I) (Instr. 5) | | | | | | | |--------------------------------------------|------------------------------|-------------------|----------------------------------| | | | | | | Common Stock, Par Value $.01 | 767,549 | D | | - -----------------------------------------------------------------------------------------------------------------------------------| 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 5(b)(v). Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currrently valid OMB control number.
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FORM 3 (Continued) - ------------------------------------------------------------------------------------------------------------------------------------ Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) - ------------------------------------------------------------------------------------------------------------------------------------ | | | | | | | |1 Title of Derivative Security |2. Date |3. Title and Amount of |4. Conversion |5. Ownership |6. Nature of | | (Instr. 4) | Exercisable and| Securities Underlying | or Exercise | Form of | Indirect | | | Expiration Date| Derivative Security | Price of | Deriva- | Beneficial | | | (Month/Day/Year)| (Instr. 4) | Derivative | tive | Ownership | | |------------------|----------------------------| Security | Security: | (Instr. 5) | | | Date | Expir- | | Amount | | Direct (D)| | | | Exer- | ation | Title | or | | or | | | | cisable| Date | | Number | | Indirect | | | | | | | of | | (I) | | | | | | | Shares | | (Instr. 5)| | | | | | | | | | | |----------------------------------|--------|---------|------------------|---------|---------------|-------------|-----------------| Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. Explanation of Responses: This statement is filed on behalf of MP Acquisition Co., LLC, the record owner of the securities, and on behalf of both MacKenzie Patterson, Inc., the manager and a controlling person of the record owner, and C.E. Patterson, an individual controlling MacKenzie Patterson, Inc. All reporting persons have the business address set forth in Item 1. Signatures of Reporting Persons MP Acquisition Co., LLC By MacKenzie Patterson, Inc., Manager By: /s/C.E. PATTERSON 9/12/2002 ---------------------------- ---------- C.E. Patterson, President Date McKenzie Patterson, Inc. By: /s/C.E. PATTERSON 9/12/2002 ---------------------------- ---------- C.E. Patterson, President Date /s/C.E. PATTERSON 9/12/2002 ------------------------------ ---------- C.E. Patterson, President Date * If the form is filed by more than one reporting person, see Instruction 5(b)(v). ** Intentional misstatement or ommissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). Note: Transmit one copy of this Form to EDGAR, using a typed signature. If space is insufficient, see Intruction 6 for procedure. Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currrently valid OMB number. Page 2
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