0001209191-11-015675.txt : 20110304
0001209191-11-015675.hdr.sgml : 20110304
20110304172855
ACCESSION NUMBER: 0001209191-11-015675
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20110302
FILED AS OF DATE: 20110304
DATE AS OF CHANGE: 20110304
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Zak Kowalczyk Mary
CENTRAL INDEX KEY: 0001508729
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-13498
FILM NUMBER: 11665836
MAIL ADDRESS:
STREET 1: W140 N8981 LILLY ROAD
CITY: MENOMONEE FALLS
STATE: WI
ZIP: 53051
ISSUER:
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
BUSINESS ADDRESS:
STREET 1: W140 N8981 LILLY ROAD
CITY: MENOMONEE FALLS
STATE: WI
ZIP: 53051
BUSINESS PHONE: 262-257-8888
MAIL ADDRESS:
STREET 1: W140 N8981 LILLY ROAD
CITY: MENOMONEE FALLS
STATE: WI
ZIP: 53051
4
1
doc4.xml
FORM 4 SUBMISSION
X0303
4
2011-03-02
0
0000929994
ASSISTED LIVING CONCEPTS INC
ALC
0001508729
Zak Kowalczyk Mary
W140 N8981 LILLY ROAD
MENOMONEE FALLS
WI
53051
0
1
0
0
Vice President
Tandem Stock Options/SARs (right to buy)
31.71
2011-03-02
4
A
0
500
0.00
A
2011-03-03
2015-03-03
Class A Common Stock
500
1000
D
/s/ Mary Zak-Kowalczyk
2011-03-04