-----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, H8Kf3ZaLZpksWnT52Odd7/s1mzetvVLSNOZcqN6BNYh3rNY6Go/VG1A48vMk6XCl tnN9laU6qMpMdJRGrk0IHw== 0000892569-97-000405.txt : 19970222 0000892569-97-000405.hdr.sgml : 19970222 ACCESSION NUMBER: 0000892569-97-000405 CONFORMED SUBMISSION TYPE: 4/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 19960801 FILED AS OF DATE: 19970214 SROS: NASD SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: AMERICAN RETIREMENT VILLAS PROPERTIES II CENTRAL INDEX KEY: 0000830156 STANDARD INDUSTRIAL CLASSIFICATION: REAL ESTATE [6500] IRS NUMBER: 330278155 STATE OF INCORPORATION: CA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4/A SEC ACT: 1934 Act SEC FILE NUMBER: 033-20413 FILM NUMBER: 97532356 BUSINESS ADDRESS: STREET 1: 245 FISCHER AVE STE D1 CITY: COSTA MESA STATE: CA ZIP: 92626 BUSINESS PHONE: 7147517400 MAIL ADDRESS: STREET 2: 245 FISCHER AVE STE D1 CITY: COSTA MESA STATE: CA ZIP: 92626 COMPANY DATA: COMPANY CONFORMED NAME: ARV ASSISTED LIVING INC CENTRAL INDEX KEY: 0000949322 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-NURSING & PERSONAL CARE FACILITIES [8050] OWNER IRS NUMBER: 330160968 STATE OF INCORPORATION: CA FISCAL YEAR END: 0331 FILING VALUES: FORM TYPE: 4/A BUSINESS ADDRESS: STREET 1: 245 FISCHER AVE STREET 2: SUITE D-1 CITY: COSTA MESA STATE: CA ZIP: 92626 BUSINESS PHONE: 7147517400 MAIL ADDRESS: STREET 1: 245 FISCHER AVENUE STREET 2: SUITE D-1 CITY: COSTA MESA STATE: CA ZIP: 92626 4/A 1 AMENDMENT TO FORM 4 1 - ------------------- FORM 4 - ------------------- [ ] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instructions 1(b) U.S. 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(f) of the Investment Company Act of 1940 - ----------------------------------------------------------------------------------------------------------------------------------- 1. Name and Address of Reporting Person 2. Issuer Name and Ticker or Trading Symbol 6. Relationship of Reporting Person to Issuer (Check all applicable) ARV Assisted Living, a California corporation American Retirement Villas Properties II Director X 10% Owner - ---------------------------------------------------------------------------------------- --- --- (Last) (First) (Middle) 3. IRS or Social Security 4. Statement for Officer (give X Other (specify Number of Reporting Month/Year --- title --- below) 245 Fischer Avenue Person (Voluntary) below) - ------------------------------------------ ---------------- Managing General Partner (Street) 33-0160968 5. If Amendment. ----------------------------------- Date of Original 7. Individual or Joint/Group Filing (Month/Year) (Check applicable line) August 1996 Form filed by one Reporting X Person --- Form filed by More than One Reporting Person --- Costa Mesa, CA 92626 - ------------------------------------------------------------------------------------------------------------------------------------ (City) (State) (Zip) Table 1--Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned - ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Security 2. Trans- 3. Trans- 4. Securities Acquired(A) 5. Amount of 6. Owner- 7. Nature (Instr. 3) action action or Disposed of (D) Securities ship of In- Date Code (Instr. 3, 4 and 5) Beneficially Form Direct Owned at Direct Bene- (Instr. 8) End of (D) or ficial (Month/ Month Indirect Owner- Day/ ------------------------------------- (Instr. 3 and (I) ship Year) Code V Amount (A) or Price 4) (Instr. (Instr. (D) 4) 4) - ------------------------------------------------------------------------------------------------------------------------------------ Limited Partnership Units 08/23/96 P 2,148.3 A $720.00 17,782.3 D - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------
* If the Form is filed by other than one Reporting Person use Instruction 4(b)(v). Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly 2 FORM 4 TABLE II - DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED (E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES)
- ------------------------------------------------------------------------------------------------------------------------- 1. TITLE OF 2. CONVER- 3. TRANS- 4. TRANSAC- 5. NUMBER OF 6. DATE EXER- 7. TITLE AND AMOUNT DERIVATIVE SION OR ACTION TION CODE DERIVATIVE CISABLE AND OF UNDERLYING SECURITY EXERCISE DATE (INSTR. 8) SECURITIES EXPIRATION SECURITIES (INSTR. 3) PRICE OF (MONTH/ ACQUIRED (A) DATE (MONTH/ (INSTR. 3 AND 4 DERIV- DAY/ OR DISPOSED OF DAY/YEAR) ATIVE YEAR) (D) (INSTR. 3, SECURITY 4, AND 5) ----------------------------------------- DATE EXPIRA- AMOUNT OR EXER- TION TITLE NUMBER OF CISABLE DATE SHARES --------------------------------- CODE V (A) (D) - ------------------------------------------------------------------------------------------------------------------------- None - ------------------------------------------------------------------------------------------------------------------------- - ------------------------------------------------------------------------------------------------------------------------- - ------------------------------------------------------------------------------------------------------------------------- - ------------------------------------------------------------------------------------------------------------------------- - ------------------------------------------------------------------------------------------------------------------------- - ------------------------------------------------------------------------------------------------------------------------- - ------------------------------------------------------------------------------------------------------------------------- - ------------------------------------------------------------------------------------------------------------------------- - ------------------------------------------------------------------------------------------------------------------------- - ------------------------------------------------------------------------------------------------------------------------- - -------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------- 8. PRICE 9. NUMBER 10. OWNER- 11. NA- OF OF DERIV- SHIP TURE DERIV- ATIVE SECUR- FORM OF IN- ATIVE ITIES OF DE- DIRECT SECUR- BENE- RIVATIVE BENE- ITY FICIALLY SECU- FICIAL INSTR. OWNED RITY: OWN- 5) AT END DIRECT ERSHIP OF (D) OR (INSTR. 4) MONTH INDI- (INSTR. 4) RECT (I) (INSTR. 4) - ------------------------------------------------------------------------------- - ------------------------------------------------------------------------------- - ------------------------------------------------------------------------------- - ------------------------------------------------------------------------------- - ------------------------------------------------------------------------------- - ------------------------------------------------------------------------------- - ------------------------------------------------------------------------------- - ------------------------------------------------------------------------------- - ------------------------------------------------------------------------------- - ------------------------------------------------------------------------------- - ------------------------------------------------------------------------------- - -------------------------------------------------------------------------------
Explanation of Responses: /s/ GARY L. DAVIDSON FEBRUARY 12, 1997 ------------------------------- ----------------- **Signature of Reporting Person Date ** Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 7811(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. -----END PRIVACY-ENHANCED MESSAGE-----