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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) | $ 7.9 | (2) | 10/08/2017 | Common Stock | 38,820 | 38,820 | D | ||||||||
Stock Option (right to buy) | $ 7.9 | (2) | 10/08/2017 | Common Stock | 6,470 | 6,470 | D | ||||||||
Restricted Stock Units | (3) | (3) | (3) | Common Stock | 66,030 (4) | 66,030 (4) | D | ||||||||
Restricted Stock Units | (5) | 08/13/2015 | 08/13/2015 | Common Stock | 2,749 | 2,749 | D | ||||||||
Restricted Stock Units | (5) | 08/31/2016 | 08/31/2016 | Common Stock | 2,045 | 2,045 | D | ||||||||
Restricted Stock Units | (5) | 08/10/2015 | A | 2,541 (6) | 08/15/2019 | 08/15/2019 | Common Stock | 2,541 | $ 0 | 2,541 | D | ||||
Restricted Stock Units | (7) | 08/10/2015 | A | 5,294 | (7) | (7) | Common Stock | 5,294 | $ 0 | 5,294 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Blackey Brent G 1225 OLD HIGHWAY 8 NW ST. PAUL, MN 55112 |
X |
/s/ Amanda Schmall as Attorney-in-Fact for Brent G. Blackey pursuant to Power of Attorney previously filed. | 08/12/2015 | |
**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 price reported in Column 4 is a weighted average price. These shares were purchased in multiple transactions at prices ranging from $22.62 to $22.89 inclusive. The reporting person undertakes to provide Cardiovascular Systems, Inc., any security holder of Cardiovascular Systems, Inc. or the staff of the Securities and Exchange Commission upon request, full information regarding the number of shares purchased at each separate price within the range set forth in this footnote. |
(2) | Fully exercisable. |
(3) | Each restricted stock unit represents the right to receive a payment from CSI equal in value to the market price per share of CSI common stock on the date of payment and shall be payable in cash or shares of Company common stock beginning six months following the termination of each director's board membership. |
(4) | Represents restricted stock units held by reporting person previously reported as separate line items. |
(5) | Each restricted stock unit represents the right to receive a payment from CSI equal in value to the market price per share of CSI common stock on the date of payment and shall be payable in cash or shares of Company common stock beginning on the payment date. |
(6) | Represents restricted stock units received at the election of the reporting person, in lieu of cash payment, as a retainer for service as a director of the Company during fiscal year 2016. |
(7) | Each restricted stock unit represents the right to receive a payment from CSI equal in value to the market price per share of CSI common stock on the date of payment and shall be payable in cash or shares of Company common stock beginning six months following the termination of each director's board membership; provided, however, that the restricted stock units vest in quarterly amounts of 1,324 shares on each of September 30, 2015 and December 31, 2015 and 1,323 shares on each of March 31, 2016 and June 30, 2016. |