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
OMB APPROVAL
OMB Number: 3235-0287
Estimated average burden
hours per response: 0.5
  
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)
08/07/2020
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 08/07/2020 J(1) 29,503 D $0 24,180 I AMK 2014 LLC as held by The Abby Miller King 2019 GRAT
Class B Common Stock 08/07/2020 J(1) 29,503 A $0 29,503 I AMK 2014 LLC as held by Alan B. Miller
Class B Common Stock 08/07/2020 J(2) 29,569 D $0 0 I AMK 2014 LLC as held by The Abby Miller King 2018 GRAT
Class B Common Stock 08/07/2020 J(2) 29,569 A $0 59,072 I AMK 2014 LLC as held by Alan B. Miller
Class B Common Stock 08/07/2020 J(1) 29,503 D $0 24,180 I MS 2014 LLC as held by The Marni Spencer 2019 GRAT
Class B Common Stock 08/07/2020 J(1) 29,503 A $0 29,503 I MS 2014 LLC as held by Alan B. Miller
Class B Common Stock 08/07/2020 J(2) 29,569 D $0 0 I MS 2014 LLC as held by The Marni Spencer 2018 GRAT
Class B Common Stock 08/07/2020 J(2) 29,569 A $0 59,072 I MS 2014 LLC as held by Alan B. Miller
Class B Common Stock 08/07/2020 J(1) 55,712 D $0 45,621 I MDM 2014 LLC as held by the Marc Daniel Miller 2019 GRAT
Class B Common Stock 08/07/2020 J(1) 55,712 A $0 55,712 I MDM 2014 LLC as held by Alan B. Miller
Class B Common Stock 08/07/2020 J(2) 74,660 D $0 0 I MDM 2014 LLC as held by The Marc Daniel Miller 2018 GRAT
Class B Common Stock 08/07/2020 J(2) 74,660 A $0 130,372 I MDM 2014 LLC as held by Alan B. Miller
Class B Common Stock 08/07/2020 J(3) 59,072 D $0 0 I AMK 2014 LLC as held by Alan B. Miller
Class B Common Stock 08/07/2020 J(3) 59,072 A $0 59,072 I AMK 2014 LLC as held by The Abby Miller King 2020 GRAT
Class B Common Stock 08/07/2020 J(4) 59,072 D $0 0 I MS 2014 LLC as held by Alan B. Miller
Class B Common Stock 08/07/2020 J(4) 59,072 A $0 59,072 I MS 2014 LLC as held by The Marni Spencer 2020 GRAT
Class B Common Stock 08/07/2020 J(5) 130,372 D $0 0 I MDM 2014 LLC as held by Alan B. Miller
Class B Common Stock 08/07/2020 J(5) 130,372 A $0 130,372 I MDM 2014 LLC as held by the Marc Daniel Miller 2020 GRAT
Class B Common Stock 671,256 D
Class B Common Stock 150,000 I Abby Miller King 2020 GRAT
Class B Common Stock 0 I AMK 2014 LLC
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 200,000 I Marc Daniel Miller 2020 GRAT
Class B Common Stock 150,000 I Marni Spencer 2020 GRAT
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 9,810 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 (6) 08/07/2020 J(1) 29,503 (7) (8) Class B Common Stock 29,503 $0 24,180 I AMK 2014 LLC as held by The Abby Miller King 2019 GRAT
Class A Common Stock (9) 08/07/2020 J(1) 29,503 (10) (11) Class B Common Stock 29,503 $0 29,503 I AMK 2014 LLC as held by Alan B. Miller
Class A Common Stock (9) 08/07/2020 J(2) 29,569 (12) (13) Class B Common Stock 29,569 $0 0 I AMK 2014 LLC held by the Abby Miller King 2018 GRAT
Class A Common Stock (9) 08/07/2020 J(2) 29,569 (10) (11) Class B Common Stock 29,569 $0 59,072 I AMK 2014 LLC as held by Alan B. Miller
Class A Common Stock (6) 08/07/2020 J(1) 29,503 (7) (8) Class B Common Stock 29,503 $0 24,180 I MS 2014 LLC as held by The Marni Spencer 2019 GRAT
Class A Common Stock (9) 08/07/2020 J(1) 29,503 (10) (11) Class B Common Stock 29,503 $0 29,503 I MS 2014 LLC as held by Alan B. Miller
Class A Common Stock (9) 08/07/2020 J(2) 29,569 (10) (11) Class B Common Stock 29,569 $0 59,072 I MS 2014 LLC as held by Alan B. Miller
Class A Common Stock (9) 08/07/2020 J(2) 29,569 (12) (13) Class B Common Stock 29,569 $0 0 I MS 2014 LLC as held by The Marni Spencer 2018 GRAT
Class A Common Stock (6) 08/07/2020 J(1) 41,783 (7) (8) Class B Common Stock 41,783 $0 34,216 I MDM 2014 LLC as held by The Marc Daniel Miller 2019 GRAT
Class A Common Stock (9) 08/07/2020 J(1) 41,783 (10) (11) Class B Common Stock 41,783 $0 41,783 I MDM 2014 LLC as held by Alan B. Miller
Class A Common Stock (9) 08/07/2020 J(2) 55,996 (12) (13) Class B Common Stock 55,996 $0 0 I MDM 2014 LLC as held by The Marc Daniel Miller 2018 GRAT
Class A Common Stock (9) 08/07/2020 J(2) 55,996 (10) (11) Class B Common Stock 55,996 $0 97,779 I MDM 2014 LLC as held by Alan B. Miller
Class A Common Stock (9) 08/07/2020 J(5) 97,779 (10) (11) Class B Common Stock 97,779 $0 0 I MDM 2014 LLC as held by Alan B. Miller
Class A Common Stock (6) 08/07/2020 J(5) 97,779 (7) (8) Class B Common Stock 97,779 $0 97,779 I MDM 2014 LLC as held by the Marc Daniel Miller 2020 GRAT
Class A Common Stock (9) 08/07/2020 J(3) 59,072 (10) (11) Class B Common Stock 59,072 $0 0 I AMK 2014 LLC as held by Alan B. Miller
Class A Common Stock (9) 08/07/2020 J(3) 59,072 (7) (8) Class B Common Stock 59,072 $0 59,072 I AMK 2014 LLC as held by The Abby Miller King 2020 GRAT
Class A Common Stock (9) 08/07/2020 J(4) 59,072 (10) (11) Class B Common Stock 59,072 $0 0 I MS 2014 LLC as held by Alan B. Miller
Class A Common Stock (6) 08/07/2020 J(4) 59,072 (7) (8) Class B Common Stock 59,072 $0 59,072 I MS 2014 LLC as held by The Marni Spencer 2020 GRAT
Class A Common Stock (14) (15) (13) Class B Common Stock 258,630 258,630 I The Alan B. Miller 2002 Trust
Class A Common Stock (9) (12) (13) Class B Common Stock 16,748 16,748 I MS 2014 LLC held by The Marni Spencer 2002 Trust
Class A Common Stock (9) (12) (13) Class B Common Stock 18,005 18,005 I MDM 2014 LLC held by The Marc Daniel Miller 2002 Trust
Class A Common Stock (9) (12) (13) Class B Common Stock 16,748 16,748 I AMK 2014 LLC held by The Abby Danielle Miller 2002 Trust
Class A Common Stock (9) (12) (16) Class B Common Stock 400,000 400,000 I Alan B. Miller Marital Trust (f/b/o Jill Miller)
Class A Common Stock (9) (15) (11) Class B Common Stock 4,155,255 4,155,255 D
Explanation of Responses:
1. On August 07, 2020, The Marc Daniel Miller 2019 GRAT distributed 27.85561% of the MDM 2014 LLC to the MDM 2014 LLC as held by Alan B. Miller, The Abby Miller King 2019 GRAT distributed 29.50298% of the AMK 2014 LLC to the AMK 2014 LLC as held by Alan B. Miller, and The Marni Spencer 2019 GRAT distributed 29.50298% 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 2019 GRAT.
2. On August 07, 2020, The Marc Daniel Miller 2018 GRAT distributed 37.33028% of the MDM 2014 LLC to the MDM 2014 LLC as held by Alan B. Miller, The Abby Miller King 2018 GRAT distributed 29.56947% of the AMK 2014 LLC to the AMK 2014 LLC as held by Alan B. Miller, and The Marni Spencer 2018 GRAT distributed 29.56947% 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.
3. On August 07, 2020, Alan B. Miller contributed 59.07245% of AMK 2014 LLC to The Abby Miller King 2020 GRAT. These shares were held by the AMK 2014 LLC as held by Alan B. Miller.
4. On August 07, 2020, Alan B. Miller contributed 59.07245% of MS 2014 LLC to The Marni Spencer 2020 GRAT. These shares were held by the MS 2014 LLC as held by Alan B. Miller
5. On August 07, 2020, Alan B. Miller contributed 65.18589% of the MDM 2014 LLC to The Marc Daniel Miller 2020 GRAT. These shares were held by the MDM 2014 LLC as held by Alan B. Miller.
6. The Class A Common Stock is convertible into Class B Common Stock on a share for share basis.
7. Immediately.
8. Not Applicable.
9. The Class A Common Stock is convertible into Class B Common Stock on a share for share basis.
10. immediately
11. Not Applicable
12. Immediately.
13. Not Applicable.
14. The Class A Common Stock is convertible into Class B Common Stock on a share for share basis.
15. Immediately
16. Not applicable.
/s/ Steve Filton, Attorney-in-Fact for Alan B. Miller 08/11/2020
** 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).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.