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 Marc D

(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 10% Owner
X Officer (give title below) Other (specify below)
President
3. Date of Earliest Transaction (Month/Day/Year)
07/30/2019
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 07/30/2019 M 45,000 A $152.47 180,237 D
Class B Common Stock 07/30/2019 F 39,028 D $152.47 141,209 D
Class B Common Stock 62,275 I AMK 2014 LLC as held by The Abby Miller King 2019 GRAT
Class B Common Stock 16,748 I AMK 2014 LLC held by The Abby Danielle Miller 2002 Trust
Class B Common Stock 20,977 I AMK 2014 LLC held by the Abby Miller King 2018 GRAT
Class B Common Stock 74,660 I MDM 2014 LLC as held by The Marc Daniel Miller 2018 GRAT
Class B Common Stock 101,333 I MDM 2014 LLC as held by The Marc Daniel Miller 2019 GRAT
Class B Common Stock 24,007 I MDM 2014 LLC held by The Marc Daniel Miller 2002 Trust
Class B Common Stock 20,977 I MS 2014 LLC as held by The Marni Spencer 2018 GRAT
Class B Common Stock 62,275 I MS 2014 LLC as held by The Marni Spencer 2019 GRAT
Class B Common Stock 16,748 I MS 2014 LLC held by The Marni Spencer 2002 Trust
Class B Common Stock 22,815 I The Abby Danielle Miller 2002 Trust
Class B Common Stock 55,763 I The Abby Miller King 2011 Family Trust
Class B Common Stock 44,110 I The Marc Daniel Miller 2002 Trust
Class B Common Stock 59,900 I The Marc Daniel Miller 2011 Family Trust
Class B Common Stock 43,247 I The Marni Spencer 2002 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
Option To Purchase Class B Common Stock $117.29 07/30/2019 M 45,000 (1) 03/17/2020 Class B Common Stock 45,000 $0 45,000 D
Option To Purchase Class B Common Stock $118.62 (2) 03/22/2021 Class B Common Stock 100,000 100,000 D
Option To Purchase Class B Common Stock $124.56 (3) 03/28/2022 Class B Common Stock 103,000 103,000 D
Option To Purchase Class B Common Stock $119.64 (4) 04/12/2023 Class B Common Stock 100,000 100,000 D
Option To Purchase Class B Common Stock $134.02 (5) 03/19/2024 Class B Common Stock 100,000 100,000 D
Explanation of Responses:
1. Option vested ratably on each of 3/18/2016, 3/18/2017, 3/18/2018 and 3/18/2019.
2. Option vests ratably on each of 3/23/2017, 3/23/2018, 3/23/2019 and 3/23/2020.
3. Option vests ratably on each of 3/29/2018, 3/29/2019, 3/29/2020 and 3/29/2021.
4. Option vests ratably on each of 4/13/2019, 4/13/2020, 4/13/2021, and 4/13/2022.
5. Option vests ratably on each of 3/20/2020, 3/20/2021, 3/20/2022, and 3/20/2023.
/s/ Marc D. Miller 07/31/2019
** 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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