0000899243-15-005068.txt : 20150921
0000899243-15-005068.hdr.sgml : 20150921
20150921143215
ACCESSION NUMBER: 0000899243-15-005068
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20150918
FILED AS OF DATE: 20150921
DATE AS OF CHANGE: 20150921
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: GI DYNAMICS, INC.
CENTRAL INDEX KEY: 0001245791
STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841]
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: ONE MAGUIRE ROAD
CITY: LEXINGTON
STATE: MA
ZIP: 02421
BUSINESS PHONE: 781-357-3310
MAIL ADDRESS:
STREET 1: ONE MAGUIRE ROAD
CITY: LEXINGTON
STATE: MA
ZIP: 02421
FORMER COMPANY:
FORMER CONFORMED NAME: GI DYNAMICS INC
DATE OF NAME CHANGE: 20030623
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: DALE MICHAEL D
CENTRAL INDEX KEY: 0001172346
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-55195
FILM NUMBER: 151117120
MAIL ADDRESS:
STREET 1: 1350 ENERGY LANE SUITE 110
CITY: ST PAUL
STATE: MN
ZIP: 55108
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2015-09-18
0
0001245791
GI DYNAMICS, INC.
GID
0001172346
DALE MICHAEL D
25 HARTWELL AVENUE
LEXINGTON
MA
02421
1
1
0
0
President and CEO
Common Stock
2015-09-18
4
M
0
20886
A
20886
D
Restricted Stock Unit (RSU)
2015-09-18
4
M
0
20886
0.00
D
2024-09-18
Common Stock
20886
62658
D
Restricted stock units convert into common stock on a one-for-one basis.
There is no exercise price associated with the RSU.
The RSU vests as to twenty-five percent (25%) of the shares on each of the first four anniversaries of the date of grant: September 18 in 2015, 2016, 2017 and 2018. In the event of a change of control of the Issuer, the RSU shall become vested in full.
/s/ Robert Solomon, attorney-in-fact
2015-09-21