0001209191-11-048735.txt : 20110922 0001209191-11-048735.hdr.sgml : 20110922 20110922154018 ACCESSION NUMBER: 0001209191-11-048735 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20110920 FILED AS OF DATE: 20110922 DATE AS OF CHANGE: 20110922 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: EVANS DOUGLAS G CENTRAL INDEX KEY: 0001225164 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34388 FILM NUMBER: 111103100 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: KENSEY NASH CORP CENTRAL INDEX KEY: 0001002811 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 363316412 STATE OF INCORPORATION: DE FISCAL YEAR END: 0630 BUSINESS ADDRESS: STREET 1: 735 PENNSYLVANIA DRIVE CITY: EXTON STATE: PA ZIP: 19341 BUSINESS PHONE: 6105947156 MAIL ADDRESS: STREET 1: 735 PENNSYLVANIA DRIVE CITY: EXTON STATE: PA ZIP: 19341 4 1 doc4.xml FORM 4 SUBMISSION X0304 4 2011-09-20 0 0001002811 KENSEY NASH CORP KNSY 0001225164 EVANS DOUGLAS G 735 PENNSYLVANIA DRIVE EXTON PA 19341 1 1 0 0 COO Common Stock 217030 I By Trust Common Stock 1050 I By Child Stock Appreciation Right 25.64 2011-09-20 4 A 0 56150 0.00 A 2018-09-20 Common Stock 56150 56150 D Shares held by Douglas G. Evans Revocable Trust, of which the Reporting Person is Trustee, for the benefit of Reporting Person and his spouse. Shares acquired by minor children of Reporting Person living in the same household as the Reporting Person. The stock appreciation right will be settled in cash only. Subject to the provisions of the award agreement and the plan under which it was issued, these Stock Appreciation Rights will vest in three equal annual installments on September 20, 2012, September 20, 2013 and September 20, 2014. /s/Douglas G. Evans, P.E. 2011-09-22