0001140361-12-004834.txt : 20120201 0001140361-12-004834.hdr.sgml : 20120201 20120201181010 ACCESSION NUMBER: 0001140361-12-004834 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20120130 FILED AS OF DATE: 20120201 DATE AS OF CHANGE: 20120201 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: POWERS CARRIE CENTRAL INDEX KEY: 0001465115 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-27605 FILM NUMBER: 12563742 MAIL ADDRESS: STREET 1: 6464 SYCAMORE COURT N. CITY: MINNEAPOLIS, STATE: MN ZIP: 55369 FORMER NAME: FORMER CONFORMED NAME: Powers Carrie DATE OF NAME CHANGE: 20090528 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: VASCULAR SOLUTIONS INC CENTRAL INDEX KEY: 0001030206 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 411859679 STATE OF INCORPORATION: MN FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 6464 SYCAMORE COURT NORTH CITY: MINNEAPOLIS STATE: MN ZIP: 55369 BUSINESS PHONE: 7636564300 MAIL ADDRESS: STREET 1: 6464 SYCAMORE COURT NORTH CITY: MINNEAPOLIS STATE: MN ZIP: 55369 4 1 doc1.xml FORM 4 X0304 4 2012-01-30 0 0001030206 VASCULAR SOLUTIONS INC VASC 0001465115 POWERS CARRIE C/O VASCULAR SOLUTIONS 6464 SYCAMORE COURT N. MINNEAPOLIS MN 55369 0 1 0 0 VP of Marketing Common Stock 700 I Owned by spouse Common Stock 39890 D Common Stock 2012-01-30 4 F 0 461 11.10 D 39429 D Common Stock 2012-02-01 4 F 0 245 10.80 D 39184 D Reporting person holds these shares indirectly and disclaims beneficial ownership of these shares. /s/ Carrie Powers 2012-02-01