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FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION OMB APPROVAL
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STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OMB NUMBER: 3235-0287
EXPIRES: SEPTEMBER 30, 1998
ESTIMATED AVERAGE
BURDEN HOURS PER
RESPONSE............... 0.5
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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).
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(f) of the Investment Company Act of 1940
(Print or Type Responses)
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1. Name and Address of Reporting Person* 2. Issuer Name and Ticker or Trading Symbol 6. Relationship of Reporting
Person(s) to Issuer
(Check all
Booty John A. ARV ASSISTED LIVING, INC. (SRS) applicable)
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(Last) (First) (Middle) X Director
__ 10% Owner
__ Officer
(give title below)
245 Fischer Avenue, Suite D-1 __ Other
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(Street)
Costa Mesa CA 92626 3. IRS or Social Security 4. Statement
- ----------------------------------------- Number of Reporting for
(City) (State) (Zip) Person (Voluntary) Month/Year
11/98
5. If Amendment, 7. Individual or Joint/Group Filing
Date of Original (Check Applicable Line)
(Month/Year)
X Form filed by One Reporting
Person
__ Form filed by More
than One Reporting Person
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TABLE I - NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED
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1. Title of Security 2. Transaction 3. Transaction 4. Securities Acquired 5. Amount 6. Ownership 7. Nature
(Instr. 3) Date Code (A) or Disposed of (D) of Form: of
(Instr. 8) (Instr. 3, 4 and 5) Securities Direct (D) Indirect
Beneficially or Beneficial
Owned Indirect Ownership
at End (I)
of Month (Instr. 4) (Instr. 4.)
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(Month/Day/Year) Code V Amount (A) or (D) Price and 4)
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Common Stock 11/2/98 G V 5,000 D N/A 364,028 I Trust
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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).
(Over)
SEC 1474 (7-96)
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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)
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1. Title of 2. Conver- 3. Trans- 4. Trans- 5. Number of 6. Date Exer- 7. Title and 8. Price
Derivative sion or action action Deriv- cisable Amount of of
Security (Instr. 3) Exercise Date Code ative and Underlying Derivative
Price of (Month/ (Instr. 8) Securities Expiration Securities Security
Derivative Day/ Acquired Date (Instr. 3 and (Instr. 5)
Security Year) (A) or (Month/Day/Year) 4)
Disposed of
(D)
(Instr. 3,
4, and 5)
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Code V (A) (D) Date Expira- Title Amount
Exer- tion Date or
cisable Number
of
Shares
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9. Number 10. Ownership 11. Nature of
of Form of Indirect
Derivative Derivative Beneficial
Securities Security; Ownership
Beneficially Direct (Instr. 4)
Owned (D) or
at End of Indirect (I)
Month
(Instr. 4) (Instr. 4)
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EXPLANATION OF RESPONSES:
** 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.
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 NUMBER.
/s/ SHEILA M. MULDOON DECEMBER 2, 1998
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** SIGNATURE OF REPORTING PERSON DATE
JOHN A. BOOTY, BY SHEILA M.
MULDOON, HIS ATTORNEY IN
FACT
