0000899243-17-014226.txt : 20170524 0000899243-17-014226.hdr.sgml : 20170524 20170524152343 ACCESSION NUMBER: 0000899243-17-014226 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170522 FILED AS OF DATE: 20170524 DATE AS OF CHANGE: 20170524 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: Stuge Oern CENTRAL INDEX KEY: 0001319750 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-55195 FILM NUMBER: 17866523 MAIL ADDRESS: STREET 1: GI DYNAMICS, INC. STREET 2: 25 HARTWELL AVENUE CITY: LEXINGTON STATE: MA ZIP: 02421 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2017-05-22 0 0001245791 GI DYNAMICS, INC. GID 0001319750 Stuge Oern 355 CONGRESS STREET BOSTON MA 02210 1 0 0 0 Stock Option (right to buy) 2.33 2017-05-22 4 A 0 8000 0.00 A 2027-04-10 Common Stock 8000 8000 D The option grant was approved by the Issuer's board of directors on April 10, 2017, subject to shareholder approval, and by the shareholders of the Issuer on May 22, 2017. The option vests in a single installment on April 10, 2018. In the event of a change of control of the Issuer, the option shall become vested in full. The board of directors of the Issuer previously approved a stock option grant to purchase 30,000 shares of the Issuer, as reported in the reporting person's Form 4 filed on January 12, 2017. The option grant was subject to shareholder approval, which was not obtained. As such, the option was not granted. /s/ Nishant M. Dharia, Attorney-in-fact 2017-05-24