0001013606-16-000212.txt : 20160302 0001013606-16-000212.hdr.sgml : 20160302 20160302123645 ACCESSION NUMBER: 0001013606-16-000212 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160229 FILED AS OF DATE: 20160302 DATE AS OF CHANGE: 20160302 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ENDOLOGIX INC /DE/ CENTRAL INDEX KEY: 0001013606 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 680328265 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 2 MUSICK CITY: IRVINE STATE: CA ZIP: 92618 BUSINESS PHONE: 9495957200 MAIL ADDRESS: STREET 1: 2 MUSICK CITY: IRVINE STATE: CA ZIP: 92618 FORMER COMPANY: FORMER CONFORMED NAME: RADIANCE MEDICAL SYSTEMS INC /DE/ DATE OF NAME CHANGE: 19990122 FORMER COMPANY: FORMER CONFORMED NAME: CARDIOVASCULAR DYNAMICS INC DATE OF NAME CHANGE: 19960506 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Chavez Christopher G. CENTRAL INDEX KEY: 0001192858 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-28440 FILM NUMBER: 161476269 MAIL ADDRESS: STREET 1: 3910 BRICKWAY BLVD. CITY: SANTA ROSA STATE: CA ZIP: 95403 FORMER NAME: FORMER CONFORMED NAME: CHAVEZ CHRISTOPHER G DATE OF NAME CHANGE: 20020925 4 1 wf-form4_145694018980571.xml FORM 4 X0306 4 2016-02-29 0 0001013606 ENDOLOGIX INC /DE/ ELGX 0001192858 Chavez Christopher G. PO BOX 670884 DALLAS TX 75367 1 0 0 0 Common Shares 2016-02-29 4 J 0 285280 0 A 312234 D Common Shares 2016-02-29 4 J 0 65640 0 A 65640 I Christopher G. Chavez Trustee of the Diana J Chavez Irrevocable Trust Common Shares 2016-02-29 4 J 0 65640 0 A 65640 I Diana J Chavez of the Trustee of the Christopher G. Chavez Family Irrevocable Trust Shares issued relate to the exchange of TriVascular, Inc shares for Endologix, Inc shares per Endologix, Inc's agreement to acquire TriVascular, Inc. Christopher G. Chavez by Timothy N. Brady, Attorney-in-Fact for Reporting Person 2016-03-02