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)
04/30/2019
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
Class B Common Stock 04/30/2019 J(1) 30,956 D $0 20,977 I AMK 2014 LLC as held by The Abby Miller King 2018 GRAT
Class B Common Stock 04/30/2019 J(1) 30,956 A $0 62,275 I AMK 2014 LLC as held by Alan B. Miller
Class B Common Stock 04/30/2019 J(1) 30,956 D $0 20,977 I MS 2014 LLC as held by The Marni Spencer 2018 GRAT
Class B Common Stock 04/30/2019 J(1) 30,956 A $0 62,275 I MS 2014 LLC as held by Alan B. Miller
Class B Common Stock 04/30/2019 J(1) 56,437 D $0 74,660 I MDM 2014 LLC as held by The Marc Daniel Miller 2018 GRAT
Class B Common Stock 04/30/2019 J(1) 56,437 A $0 101,333 I MDM 2014 LLC as held by Alan B. Miller
Class B Common Stock 04/30/2019 J(2) 62,275 D $0 0 I AMK 2014 LLC as held by Alan B. Miller
Class B Common Stock 04/30/2019 J(2) 62,275 A $0 62,275 I AMK 2014 LLC as held by The Abby Miller King 2019 GRAT
Class B Common Stock 04/30/2019 J(3) 62,275 D $0 0 I MS 2014 LLC as held by Alan B. Miller
Class B Common Stock 04/30/2019 J(3) 62,275 A $0 62,275 I MS 2014 LLC as held by The Marni Spencer 2019 GRAT
Class B Common Stock 04/30/2019 J(4) 101,333 D $0 0 I MDM 2014 LLC as held by Alan B. Miller
Class B Common Stock 04/30/2019 J(4) 101,333 A $0 101,333 I MDM 2014 LLC as held by the Marc Daniel Miller 2019 GRAT
Class B Common Stock 1,156,860 D
Class B Common Stock 16,748 I AMK 2014 LLC held by The Abby Danielle Miller 2002 Trust
Class B Common Stock 55,763 I By The Abby Miller King 2011 Family Trust
Class B Common Stock 24,007 I MDM 2014 LLC held by The Marc Daniel Miller 2002 Trust
Class B Common Stock 16,748 I MS 2014 LLC held by The Marni Spencer 2002 Trust
Class B Common Stock 10,810 I The Alan and Jill Miller Foundation
Class B Common Stock 59,900 I The Marc Daniel Miller 2011 Family Trust
Class B Common Stock 55,763 I The Marni Spencer 2011 Family Trust
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 (5) 04/30/2019 J(1) 30,956 (6) (7) Class B Common Stock 30,956 $0 20,977 I AMK 2014 LLC held by the Abby Miller King 2018 GRAT
Class A Common Stock (5) 04/30/2019 J(1) 30,956 (8) (9) Class B Common Stock 30,956 $0 62,275 I AMK 2014 LLC as held by Alan B. Miller
Class A Common Stock (5) 04/30/2019 J(1) 30,956 (6) (7) Class B Common Stock 30,956 $0 20,977 I MS 2014 LLC as held by The Marni Spencer 2018 GRAT
Class A Common Stock (5) 04/30/2019 J(1) 30,956 (8) (9) Class B Common Stock 30,956 $0 62,275 I MS 2014 LLC as held by Alan B. Miller
Class A Common Stock (5) 04/30/2019 J(1) 42,328 (6) (7) Class B Common Stock 42,328 $0 55,996 I MDM 2014 LLC as held by The Marc Daniel Miller 2018 GRAT
Class A Common Stock (5) 04/30/2019 J(1) 42,328 (8) (9) Class B Common Stock 42,328 $0 75,999 I MDM 2014 LLC as held by Alan B. Miller
Class A Common Stock (5) 04/30/2019 J(2) 62,275 (8) (9) Class B Common Stock 62,275 $0 0 I AMK 2014 LLC as held by Alan B. Miller
Class A Common Stock (10) 04/30/2019 J(2) 62,275 (11) (12) Class B Common Stock 62,275 $0 62,275 I AMK 2014 LLC as held by The Abby Miller King 2019 GRAT
Class A Common Stock (5) 04/30/2019 J(3) 62,275 (8) (9) Class B Common Stock 62,275 $0 0 I MS 2014 LLC as held by Alan B. Miller
Class A Common Stock (10) 04/30/2019 J(3) 62,275 (11) (12) Class B Common Stock 62,275 $0 62,275 I MS 2014 LLC as held by The Marni Spencer 2019 GRAT
Class A Common Stock (5) 04/30/2019 J(4) 75,999 (8) (9) Class B Common Stock 75,999 $0 0 I MDM 2014 LLC as held by Alan B. Miller
Class A Common Stock (10) 04/30/2019 J(4) 75,999 (11) (12) Class B Common Stock 75,999 $0 75,999 I MDM 2014 LLC as held by The Marc Daniel Miller 2019 GRAT
Class A Common Stock (5) (6) (7) Class B Common Stock 16,748 16,748 I AMK 2014 LLC held by The Abby Danielle Miller 2002 Trust
Class A Common Stock (5) (13) (9) Class B Common Stock 4,155,255 4,155,255 D
Class A Common Stock (5) (6) (14) Class B Common Stock 400,000 400,000 I Alan B. Miller Marital Trust (f/b/o Jill Miller)
Class A Common Stock (5) (6) (7) Class B Common Stock 18,005 18,005 I MDM 2014 LLC held by The Marc Daniel Miller 2002 Trust
Class A Common Stock (5) (6) (7) Class B Common Stock 16,748 16,748 I MS 2014 LLC held by The Marni Spencer 2002 Trust
Class A Common Stock (15) (13) (7) Class B Common Stock 258,630 258,630 I The Alan B. Miller 2002 Trust
Explanation of Responses:
1. On April 30, 2019, The Marc Daniel Miller 2018 GRAT distributed 28.21838% of the MDM 2014 LLC to the MDM 2014 LLC as held by Alan B. Miller, The Abby Miller King 2018 GRAT distributed 30.95556% of the AMK 2014 LLC to the AMK 2014 LLC as held by Alan B. Miller, and The Marni Spencer 2018 GRAT distributed 30.95556% of the MS 2014 LLC to the MS 2014 LLC as held by Alan B. Miller. Mr. Miller's pecuniary interest in these shares is unchanged. All distributions hereinbefore described were made pursuant to the terms of the Trust Agreement creating each 2018 GRAT.
2. On April 30, 2019, Alan B. Miller contributed 62.27585% of AMK 2014 LLC to The Abby Miller King 2019 GRAT. These shares were held by the AMK 2014 LLC as held by Alan B. Miller.
3. On April 30, 2019, Alan B. Miller contributed 62.27585% of MS 2014 LLC to The Marni Spencer 2019 GRAT. These shares were held by the MS 2014 LLC as held by Alan B. Miller
4. On April 30, 2019, Alan B. Miller contributed 50.66610% of the MDM 2014 LLC to The Marc Daniel Miller 2019 GRAT. These shares were held by the MDM 2014 LLC as held by Alan B. Miller.
5. The Class A Common Stock is convertible into Class B Common Stock on a share for share basis.
6. Immediately.
7. Not Applicable.
8. immediately
9. Not Applicable
10. The Class A Common Stock is convertible into Class B Common Stock on a share for share basis.
11. Immediately.
12. Not Applicable.
13. Immediately
14. Not applicable.
15. The Class A Common Stock is convertible into Class B Common Stock on a share for share basis.
/s/ Steve Filton, Attorney-in-Fact for Alan B. Miller 05/01/2019
** Signature of Reporting Person Date
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