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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 | ||||||||
Stock Option (Right to Buy) | $ 2.53 | 03/22/2011 | M | 35,000 | 09/15/2005 | 09/15/2015 | Common Stock | 35,000 | $ 0 | 0 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
YOUNG RODNEY A 350 OAK GROVE PARKWAY SAINT PAUL, MN 55127 |
X |
Robert D. Bubalo, Attorney-in-Fact for Rodney A. Young | 04/05/2011 | |
**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) | The Reporting Person was granted 26,667 shares of restricted stock on August 28, 2008. One-third of the shares vested on the first and second anniversaries of the date of grant. The remaining 8,889 shares were forfeited when the Reporting Person stepped down as President and CEO of the Issuer effective December 31, 2010. |
(2) | The Reporting Person was granted 33,333 shares of restricted stock on June 3, 2009. One-third of the shares vested on the first anniversary of the date of grant. The remaining 22,222 shares were forfeited when the Reporting Person stepped down as President and CEO of the Issuer effective December 31, 2010. |
(3) | This Form 4 reports the delivery by attestation to the Issuer of 18,109 shares of stock already owned by the Reporting Person to pay the exercise price for 24,500 incentive stock options and 10,500 nonqualified stock options. |
(4) | The Reporting Person is required to pay the tax withholding obligation associated with the exercise of nonqualified stock options. Therefore, the Reporting Person has delivered by attestation to the Issuer 1,657 shares of stock already owned for the payment of this obligation. This Amended Form 4 corrects the number of shares previously reported for the tax withholding. |
(5) | The price of $4.89 is equal to the fair market value on the date of exercise and is used to determine the value of the shares delivered by attestation to the Issuer for payment of both the option exercise price and the tax withholding obligation. The Board of Directors expressly authorized delivery by attestation for the Reporting Person. |
(6) | Includes 370 shares acquired under the Angeion Corporation 2003 Employee Stock Purchase Plan on December 31, 2010. |