Form 4 Hicks George T

4 - Statement of changes in beneficial ownership of securities

Published: 2006-07-27 16:58:41
Submitted: 2006-07-27
Period Ending In: 2006-07-25
edgar123.html FORM 4


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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
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*
HICKS GEORGE T

(Last) (First) (Middle)
111 WESTWOOD PLACE
SUITE 200

(Street)
BRENTWOOD TN 37027

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
Brookdale Senior Living Inc. [ BKD ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Executive Vice President
3. Date of Earliest Transaction (Month/Day/Year)
07/25/2006
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
Common Stock 07/25/2006 A 52,074 A $38.07(1) 52,074 D
Common Stock 07/25/2006 A 52,074 A $0.00(1) 104,148 D
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
Explanation of Responses:
1. Acquisition of Common Stock and corresponding grant of restricted Common Stock under the Brookdale Senior Living Inc. Omnibus Stock Incentive Plan, pursuant to an employment agreement by and between the Issuer and the Reporting Person, entered into as of May 12, 2006 and effective as of the consummation of the acquisition of American Retirement Corporation by the Issuer on July 25, 2006.
/s/ George T. Hicks 07/25/2006
** 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.
1
edgar123.xml FORM 4
Schema Version:
X0202
Document Type:
4
Period Of Report:
2006-07-25
Not Subject To Section16:
0

Issuer

Issuer Cik
0001332349
Issuer Name
Brookdale Senior Living Inc.
Issuer Trading Symbol
BKD

Reporting Owner

Reporting Owner Id

Rpt Owner Cik
0001251139
Rpt Owner Name
HICKS GEORGE T

Reporting Owner Address

Rpt Owner Street1
111 WESTWOOD PLACE
Rpt Owner Street2
SUITE 200
Rpt Owner City
BRENTWOOD
Rpt Owner State
TN
Rpt Owner Zip Code
37027

Reporting Owner Relationship

Is Director
0
Is Officer
1
Is Ten Percent Owner
0
Is Other
0
Officer Title
Executive Vice President

Non Derivative Transaction

Security Title
Common Stock
Transaction Date
2006-07-25

Transaction Coding

Transaction Form Type
4
Transaction Code
A
Equity Swap Involved
0

Transaction Amounts

Transaction Shares
52074

Transaction Price Per Share

Value
38.07
@attributes Id
F1
Transaction Acquired Disposed Code
A
Shares Owned Following Transaction
52074
Direct Or Indirect Ownership
D
Security Title
Common Stock
Transaction Date
2006-07-25

Transaction Coding

Transaction Form Type
4
Transaction Code
A
Equity Swap Involved
0

Transaction Amounts

Transaction Shares
52074

Transaction Price Per Share

Value
0.00
@attributes Id
F1
Transaction Acquired Disposed Code
A
Shares Owned Following Transaction
104148
Direct Or Indirect Ownership
D
Footnotes Footnote
Acquisition of Common Stock and corresponding grant of restricted Common Stock under the Brookdale Senior Living Inc. Omnibus Stock Incentive Plan, pursuant to an employment agreement by and between the Issuer and the Reporting Person, entered into as of May 12, 2006 and effective as of the consummation of the acquisition of American Retirement Corporation by the Issuer on July 25, 2006.

Owner Signature

Signature Name
/s/ George T. Hicks
Signature Date
2006-07-25
Additional Files
FileSequenceDescriptionTypeSize
0001005477-06-003720.txt   Complete submission text file   6632
$BKD

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