SEC FORM 4 SEC Form 4
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
or Section 30(h) of the Investment Company Act of 1940
 
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
MILLER ALAN B

(Last) (First) (Middle)
UNIVERSAL HEALTH SERVICES, INC.
367 SOUTH GULPH ROAD

(Street)
KING OF PRUSSIA PA 19406

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
UNIVERSAL HEALTH SERVICES INC [ UHS ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director X 10% Owner
X Officer (give title below) Other (specify below)
Chairman and CEO
3. Date of Earliest Transaction (Month/Day/Year)
11/26/2013
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
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. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
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. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Class A Common Stock (1) 11/26/2013 J(2) 27,848 (4) (5) Class B Common Stock 27,848 $0 29,652 I By The Abby Miller King 2011 GRAT
Class A Common Stock (1) 11/26/2013 J(2) 27,848 (4) (5) Class B Common Stock 27,848 $0 4,112,374 D
Class A Common Stock (1) 11/26/2013 J(2) 27,848 (4) (5) Class B Common Stock 27,848 $0 29,652 I By The Marc Daniel Miller 2011 GRAT
Class A Common Stock (1) 11/26/2013 J(2) 27,848 (4) (5) Class B Common Stock 27,848 $0 4,140,222 D
Class A Common Stock (1) 11/26/2013 J(2) 27,848 (4) (5) Class B Common Stock 27,848 $0 29,652 I By The Marni Spencer 2011 GRAT
Class A Common Stock (1) 11/26/2013 J(2) 27,848 (4) (5) Class B Common Stock 27,848 $0 4,168,070 D
Class A Common Stock (1) 11/26/2013 J(3) 29,652 (4) (5) Class B Common Stock 29,652 $0 0 I By The Abby Miller King 2011 GRAT
Class A Common Stock (1) 11/26/2013 J(3) 29,652 (4) (5) Class B Common Stock 29,652 $0 0 I By The Marc Daniel Miller 2011 GRAT
Class A Common Stock (1) 11/26/2013 J(3) 29,652 (4) (5) Class B Common Stock 29,652 $0 0 I By The Marni Spencer 2011 GRAT
Explanation of Responses:
1. The Class A Common Stock is convertible into Class B Common Stock on a share for share basis.
2. On November 26, 2013, each of The Abby Miller King 2011 GRAT, The Marc Daniel Miller 2011 GRAT and The Marni Spencer 2011 GRAT terminated and pursuant to its terms distributed 27,848 shares of Class A Common Stock to Alan B. Miller.The distribution resulted in a change of beneficial ownership from indirect to direct. Mr. Miller's pecuniary interest in these shares is unchanged.
3. On November 26, 2013, each of The Abby Miller King 2011 GRAT, The Marc Daniel Miller 2011 GRAT and The Marni Spencer 2011 GRAT terminated pursuant to its terms distributed 29,652 shares of Class A Common Stock to certain Trusts for the benefit of Mr. Miller's family. Mr. Miller has no beneficial or pecuniary interest in those trusts.
4. Immediately
5. Not Applicable
/s/ Alan B. Miller 11/27/2013
** Signature of Reporting Person Date
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).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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