0001209191-11-028661.txt : 20110516 0001209191-11-028661.hdr.sgml : 20110516 20110516172815 ACCESSION NUMBER: 0001209191-11-028661 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20110512 FILED AS OF DATE: 20110516 DATE AS OF CHANGE: 20110516 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Godshall Douglas Evan CENTRAL INDEX KEY: 0001404227 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34256 FILM NUMBER: 11848852 MAIL ADDRESS: STREET 1: SUITE 4 LEVEL 46 2 PARK STREET CITY: SIDNEY STATE: C3 ZIP: 2000 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 4 1 doc4.xml FORM 4 SUBMISSION X0303 4 2011-05-12 0 0001389072 HeartWare International, Inc. HTWR 0001404227 Godshall Douglas Evan C/O HEARTWARE INTERNATIONAL, INC. 205 NEWBURY STREET, SUITE 101 FRAMINGHAM MA 01701 1 1 0 0 President & Chief Exec Officer Restricted Stock Unit 2011-05-12 4 A 0 22450 0.00 A 2014-12-20 Common Stock 22450 102450 D 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 December 20, 2011, December 20, 2012, December 20, 2013 and December 20, 2014. /s/ David McIntyre as Attorney-in-Fact 2011-05-16