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) Page 1 of 2 SEC 1474(02-02)
- ----------- ------------------------ FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION OMB APPROVAL - ----------- ------------------------ Washington, D.C. 20549 OMB Number 3235-0287 Expires: January 31, 2005 Estimated average burden STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP hours per response ...0.5 ------------------------- 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 of Section 30(I) of the Investment Company Act of 1940 [_] Check box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instructions 1(b). (Print or Type Responses) - ------------------------------------------------------------------------------------------------------------------------------------ 1. Name and Address of Reporting Person* 2. Issuer Name and Ticker or Trading Symbol 6. Relationship of Universal Health Services, Inc Reporting Person(s) to Issuer Herrell, John H. "UHS" (Check all applicable) - -------------------------------------------------------------------------------------------- (Last) (First) (Middle) 3. IRS Identification 4. Statement for X Director __10% Owner --- 1021 10th Street, S.W. Number of Reporting (Month/Year) ___Officer (give __ Other (specify Person, If an entity title below) below) (Voluntary) 08-2002 --------------------- - ----------------------------------------- 5. If Amendment, ---------------------------------------- (Street) Date of Original 7. Individual or Joint/Group Filing Month/Year (Check Applicable Line) X Form filed by One Reporting Person --- ___ Form filed by More than One Rochester, MN 55902 Reporting Person - ------------------------------------------------------------------------------------------------------------------------------------ (City) (State) (Zip) Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned - ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of 2. Trans- 3. Trans- 4. Securities Acquired (A) 5. Amount of 6. Owner- 7. Nature of Indirect Security action action or Disposed of (D) Securities Ship Beneficial Ownership (Instr. 3) Date Code (Instr. 3, 4 and 5) Beneficially Form: (Instr. 4) (Instr. Owned at Direct (D) (Month/ 8) End of Month or Day/ -------------------------------------------- Year) Code V Amount (A) or Price Indirect (I) (D) (Instr. 3 and 4) (Instr. 4) - ------------------------------------------------------------------------------------------------------------------------------------ Common B 08-23-2002 S 700 D $46.60 D - ------------------------------------------------------------------------------------------------------------------------------------ Common B 08-23-2002 S 4,100 D $46.56 2,000 D - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ FORM 4 (continued) Table II - Derivative Securities Acquired, Disposed of, or Beneficially owned (e.g., puts, calls, warrants, options, convertable securities) - ------------------------------------------------------------------------------------------------------------------------------------
** 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 is insufficient, see instruction 8 for procedure. /s/ John H. Herrell 08/26/2002 ---------------------------------------------------- ------------------- **Signature of Reporting Person: Date Potential persons who are to respond to the collection of information contained in this form are noted required to respond unless the forms displays a currently valid OMB Number. Page 2 of 2 SEC 1474 (02-02)1. Title of Derivative 2. Conver- 3. Trans- 4. Trans- 5. Number of Deriv- 6. Date exer- 7. Title and Amount Security sion or action action ative Securities Ac- cisable and Ex- of Underlying (Instr. 3) Exercise Date Code quired (A) or Dis- piration Date Securities Price of (Month/ (Instr. 8) posed of (D) (Month/Day/Year) (Instr. 3 and 4) Deriv- Day/ (Instr. 3, 4 and 5) ative Year) --------------------------------------- Security Date Expira- -------------------------------------- c Exer- tion Title Amount or o cisable Date Number of d V (A) (D) Shares e - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - --------------------------------------------------------------------------------------- 8. Price 9. Number 10. Owner- 11. Nature of of Deriv- Ship of Derivative ative Form Indirect (Instr. 5) Secur- of Deri- Beneficial ities vative Ownership Bene- Security: (Instr. 4) fically Direct (D) Owned or Indi- at end rect (I) of (Instr. 4) Month (Instr. 4) - --------------------------------------------------------------------------------------- - --------------------------------------------------------------------------------------- - --------------------------------------------------------------------------------------- - --------------------------------------------------------------------------------------- - --------------------------------------------------------------------------------------- - ---------------------------------------------------------------------------------------