SEC FORM 4/A 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)
11/12/2014
4. If Amendment, Date of Original Filed (Month/Day/Year)
11/13/2014
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
Class B Common Stock 11/12/2014 J(1) 100,000 D $0 717,782 D
Class B Common Stock 11/12/2014 J(1) 100,000 A $0 100,000 I AMK 2014 LLC
Class B Common Stock 11/12/2014 J(1) 100,000 D $0 617,782 D
Class B Common Stock 11/12/2014 J(1) 100,000 A $0 100,000 I MDM 2014 LLC
Class B Common Stock 11/12/2014 J(1) 100,000 D $0 517,782 D
Class B Common Stock 11/12/2014 J(1) 100,000 A $0 100,000 I MS 2014 LLC
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 (2) 11/12/2014 J(1) 100,000 (3) (4) Class B Common Stock 100,000 $0 4,273,550 D
Class A Common Stock (2) 11/12/2014 J(1) 100,000 (3) (4) Class B Common Stock 100,000 $0 100,000 I AMK 2014 LLC
Class A Common Stock (2) 11/12/2014 J(1) 150,000 (3) (4) Class B Common Stock 150,000 $0 4,123,550 D
Class A Common Stock (2) 11/12/2014 J(1) 150,000 (3) (4) Class B Common Stock 150,000 $0 150,000 I MDM 2014 LLC
Class A Common Stock (2) 11/12/2014 J(1) 100,000 (3) (4) Class B Common Stock 100,000 $0 4,023,550 D
Class A Common Stock (2) 11/12/2014 J(1) 100,000 (3) (4) Class B Common Stock 100,000 $0 100,000 I MS 2014 LLC
Explanation of Responses:
1. This Amendment is to correct the date reported in Footnote 1 to November 12, 2014. On November 12, 2014, Mr. Alan B. Miller transferred 150,000 shares of Class A Common Stock to the MDM 2014 LLC and transferred 100,000 shares of Class A Common Stock to each of the AMK 2014 LLC and the MS 2014 LLC. On November 12, 2014, Mr. Alan B. Miller transferred 100,000 shares of Class B Common Stock to each of the AMK 2014 LLC, the MDM 2014 LLC and the MS 2014 LLC. These shares were previously directly held by Mr. Alan B. Miller and the transfer resulted in a change of beneficial ownership from direct to indirect. Mr. Alan B. Miller's pecuniary interest in these shares is unchanged. It is contemplated that following the transfers referred to above, the 100% ownership interest in the AMK 2014 LLC will be transferred to The Abby Miller King 2014 GRAT. The 100% ownership interest in the MDM 2014 LLC will be transferred to The Marc Daniel Miller 2014 GRAT. The 100% ownership interest in the MS 2014 LLC will be transferred to The Marni Spencer 2014 GRAT. Alan B. Miller's pecuniary interest in these shares will be unchanged. Marc D. Miller disclaims any pecuniary interest in these shares.
2. The Class A Common Stock is convertible into Class B Common Stock on a share for share basis.
3. Immediately
4. Not Applicable
/s/ Alan B. Miller 11/14/2014
** Signature of Reporting Person Date
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