0001209191-11-028671.txt : 20110516 0001209191-11-028671.hdr.sgml : 20110516 20110516173302 ACCESSION NUMBER: 0001209191-11-028671 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20110512 FILED AS OF DATE: 20110516 DATE AS OF CHANGE: 20110516 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: HeartWare International, Inc. CENTRAL INDEX KEY: 0001389072 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 980498958 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 14000 NW 57TH COURT CITY: MIAMI LAKES STATE: FL ZIP: 33014 BUSINESS PHONE: 508-739-0841 MAIL ADDRESS: STREET 1: 205 NEWBURY STREET STREET 2: SUITE 101 CITY: FRAMINGHAM STATE: MA ZIP: 01701 FORMER COMPANY: FORMER CONFORMED NAME: HeartWare LTD DATE OF NAME CHANGE: 20070206 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: LARKIN C RAYMOND JR CENTRAL INDEX KEY: 0001034464 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34256 FILM NUMBER: 11848956 MAIL ADDRESS: STREET 1: C/O MALLINCKRODT INC STREET 2: 7733 FORSYTH BLVD CITY: ST LOUIS STATE: MO ZIP: 63105 4 1 doc4.xml FORM 4 SUBMISSION X0303 4 2011-05-12 0 0001389072 HeartWare International, Inc. HTWR 0001034464 LARKIN C RAYMOND JR C/O HEARTWARE INTERNATIONAL, INC. 205 NEWBURY STREET, SUITE 101 FRAMINGHAM MA 01701 1 0 0 0 Stock Option (right to buy) 79.01 2011-05-12 4 A 0 1000 0.00 A 2021-05-12 Common Stock 1000 2000 D Restricted Stock Unit 2011-05-12 4 A 0 1000 0.00 A 2015-05-12 Common Stock 1000 3354 D The stock options become exercisable in four equal installments on the anniversary of the date of grant (May 12, 2012, May 12, 2013, May 12, 2014 and May 12, 2015) subject to Mr. Larkin's continuous service as a director of the Company through each such anniversary date. In addition, the stock options will immediately vest upon the occurrence of a change in control (as defined in the 2008 Stock Incentive Plan) or upon Mr. Larkin's death prior to settlement. Each restricted stock unit represents a contingent right to receive one share of the Company's common stock. The restricted stock units become exercisable in four equal installments on the anniversary of the date of grant (May 12, 2012, May 12, 2013, May 12, 2014 and May 12, 2015) subject to Mr. Larkin's continuous service as a director of the Company through each such anniversary date. In addition, the restricted stock units will immediately vest upon the occurrence of a change in control (as defined in the 2008 Stock Incentive Plan) or upon Mr. Larkin's death prior to settlement. /s/ David McIntyre as Attorney-in-Fact 2011-05-16