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FORM 4
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U.S. SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, DC 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
/X/ Check box if no
longer subject to Filed pursuant to Section 16(a) of the Securities
Section 16. Form 4 Exchange Act of 1934, Section 17(a) of the
or Form 5 obligations Public Utility Holding Company Act of 1935
may continue. See or Section 30(f) of the Investment Company
Instruction 1(b). Act of 1940
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<S> <C> <C> <C> <C> <C> <C>
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1. Name and Address of Reporting Person* 2. Issuer Name and Ticker or Trading Symbol 6. Relationship of Reporting Person to
Golder, Thoma, Cressey, Rauner Fund IV, L.P. Province Healthcare Company (PRHC) Issuer (Check all applicable)
- --------------------------------------------- ---------------------------------------------- Director 10% Owner
(Last) (First) (Middle) 3. IRS or Social Security 4. Statement for ---- ---
6100 Sears Tower Number of Reporting Month/Year Officer (give X Other (Specify
- --------------------------------------------- Person (Voluntary) 8/99 ---- title --- below)
(Street) ------------------ below)
Chicago IL 60606 5. If Amendment, Former 10% owner
- --------------------------------------------- Date of Original --------------------------------
(City) (State) (Zip) (Month/Year)
7. Individual or Joint/Group Filing
------------------ (Check applicable line)
X Form filed by one
---- Reporting Person
Form filed by more than
---- one Reporting Person
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TABLE 1 -- NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED
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1. Title of Security 2. Trans- 3. Transac- 4. Securities Acquired (A) 5. Amount of Se- 6. Owner- 7. Nature
(Instr. 3) action tion or Disposed of (D) curities Benefi- ship of In-
Date Code (Instr. 3, 4 and 5) cially Owned at Form: direct
(Instr. 8) End of Month Direct Benefi-
(Month/ (Instr. 3 and 4) (D) or cial
Day/ --------------------------------------- Indirect Owner-
Year) Code V Amount (A) or Price (I) ship
(D) (Instr. 4) (Instr.
4)
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Common Stock 8/31/99 J 600,000 D 1,101,258 D
(See Note 1) shares shares
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*If the Form is filed by more than one Reporting Person, see Instruction 4(b)(v).
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Over)
SEC 1474 (7-97)
Potential persons who are to 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.
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FORM 4 (CONTINUED) TABLE II -- DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED
(E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES)
<S> <C> <C> <C> <C> <C> <C> <C>
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|1. Title of Derivative | 2. Conver- |3. Trans- |4. Trans- | 5. Number of | 6. Date Exer- | 7. Title and Amount |8. Price |
| Security | sion or | action | action | Derivative | cisable and | of Underlying | of |
| (Instr. 3) | Exercise | Date | Code | Securities | Expiration | Securities | Deriv- |
| | Price of | (Month/| (Instr.| Acquired (A)| Date | (Instr. 3 and 4) | ative |
| | Deriv- | Day/ | 8) | or Disposed | (Month/Day/ | | Secur- |
| | ative | Year) | | or (D) | Year) | | ity |
| | Security | | | (Instr. 3, | | | (Instr. 5)|
| | | | | 4, and 5) |----------------|---------------------| |
| | | | | | Date |Expira-| | Amount or| |
| | | |----------|----------------| Exer- |tion | Title | Number of| |
| | | | Code| V | (A) | (D) | cisable|Date | | Shares | |
|-----------------------|--------------|----------|-----|----|--------|-------|--------|-------|---------|-----------|-------------|
| | | | | | | | | | | | |
|-----------------------|--------------|----------|-----|----|--------|-------|--------|-------|---------|-----------|-------------|
| | | | | | | | | | | | |
|-----------------------|--------------|----------|-----|----|--------|-------|--------|-------|---------|-----------|-------------|
| | | | | | | | | | | | |
|-----------------------|--------------|----------|-----|----|--------|-------|--------|-------|---------|-----------|-------------|
| | | | | | | | | | | | |
|-----------------------|--------------|----------|-----|----|--------|-------|--------|-------|---------|-----------|-------------|
| | | | | | | | | | | | |
|-----------------------|--------------|----------|-----|----|--------|-------|--------|-------|---------|-----------|-------------|
| | | | | | | | | | | | |
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<S> <C> <C>
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| 9. Number of | 10. Ownership | 11. Nature of |
| Derivative | Form of | Indirect |
| Securities | Derivative | Beneficial |
| Beneficially | Security: | Ownership |
| Owned at End | Direct (D) | (Instr. 4) |
| of Month | or Indirect (I) | |
| (Instr. 4) | (Instr. 4) | |
| | | |
|---------------------|-------------------------------|----------------------|
| | | |
|---------------------|-------------------------------|----------------------|
| | | |
|---------------------|-------------------------------|----------------------|
| | | |
|---------------------|-------------------------------|----------------------|
| | | |
|---------------------|-------------------------------|----------------------|
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|---------------------|-------------------------------|----------------------|
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Explanation of Responses:
NOTE 1: DISTRIBUTION TO PARTNERS OF REPORTING PERSON.
By: GTCR IV, L.P.,
its general partner
** Intentional misstatements or omissions of facts constitute Federal Criminal
Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). By: Golder, Thoma, Cressey, Rauner, Inc.,
its general partner
9/10/99
Note. File three copies of this Form, one of which must be manually signed. -------------------------------- ----------
If space is insufficient, see Instruction 6 for procedure. **Signature of Reporting Person Date
BRUCE V. RAUNER,
Potential persons who are to respond to the collection of information PRINCIPAL
contained in this form are not required to respond unless the form displays a
currently valid OMB Number.
Page 2
SEC 1474 (&-97)
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