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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES 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 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
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 control number. | SEC 1474 (9-02) |
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 Underlying Securities (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 of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Non-Qualified Stock Option (right to buy) | $ 32.2707 | 11/17/2006 | D | 14,733 | 05/15/2002 | 05/15/2008 | Common Stock | 14,733 | (2) | 0 | D | ||||
Non-Qualified Stock Option (right to buy) | $ 39.2 | 11/17/2006 | D | 6,950 | (3) | 05/24/2011 | Common Stock | 6,950 | (2) | 0 | D | ||||
Non-Qualified Stock Option (right to buy) | $ 32.3 | 11/17/2006 | D | 6,179 | 07/24/2003 | 07/24/2013 | Common Stock | 6,179 | (2) | 0 | D | ||||
Non-Qualified Stock Option (right to buy) | $ 40.14 | 11/17/2006 | D | 6,229 | (4) | 06/10/2014 | Common Stock | 6,229 | (2) | 0 | D | ||||
Non-Qualified Stock Option (right to buy) | $ 43.49 | 11/17/2006 | D | 3,833 | (4) | 05/25/2016 | Common Stock | 3,833 | (2) | 0 | D | ||||
Non-Qualified Stock Option (right-to-buy) | $ 54.68 | 11/17/2006 | D | 5,715 | (4) | 06/09/2015 | Common Stock | 5,715 | (5) | 0 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
LONG T MICHAEL C/O HCA INC. ONE PARK PLAZA NASHVILLE, TN 37203 |
X |
By: /s/ Colleen E. Haley, Attorney-in-Fact | 11/21/2006 | |
**Signature of Reporting Person | Date |
* | 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). |
(1) | Disposed of in connection with the merger in exchange for the right to receive $51.00 per share. |
(2) | This option was cancelled in the merger in exchange for a cash payment equal to the difference between the exercise price of the option and the merger consideration of $51 per share, multiplied by the number of shares subject to the option. |
(3) | The option vests in five equal annual installments beginning on 5/24/01. |
(4) | Immediately before the effective time of the merger, all unvested options became fully vested and immediately exercisable. |
(5) | All options with an exercise price above the merger consideration of $51.00 per share were cancelled in the merger and no payment will be made thereon. |