0000899243-18-028959.txt : 20181114 0000899243-18-028959.hdr.sgml : 20181114 20181114194647 ACCESSION NUMBER: 0000899243-18-028959 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20181112 FILED AS OF DATE: 20181114 DATE AS OF CHANGE: 20181114 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Schorer Scott CENTRAL INDEX KEY: 0001670397 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-55195 FILM NUMBER: 181185712 MAIL ADDRESS: STREET 1: 25 HARTWELL AVENUE STREET 2: C/O GI DYNAMICS, INC. CITY: LEXINGTON STATE: MA ZIP: 02421 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: 745 ATLANTIC AVE STREET 2: OFFICE NO. 708 CITY: BOSTON STATE: MA ZIP: 02111 BUSINESS PHONE: 781-357-3310 MAIL ADDRESS: STREET 1: 745 ATLANTIC AVE STREET 2: OFFICE NO. 708 CITY: BOSTON STATE: MA ZIP: 02111 FORMER COMPANY: FORMER CONFORMED NAME: GI DYNAMICS INC DATE OF NAME CHANGE: 20030623 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2018-11-12 0 0001245791 GI DYNAMICS, INC. GID 0001670397 Schorer Scott 745 ATLANTIC AVENUE, OFFICE NO. 708 BOSTON MA 02111 0 1 0 0 President and CEO Stock Option (right to buy) 0.72 2018-11-12 4 A 0 300000 0.00 A 2018-11-12 Common Stock 300000 300000 D The option vests over a four (4) year period, with one quarter (1/4) of the shares vesting on the one (1) year anniversary of the date of grant, and the remaining shares vesting in equal amounts on a monthly basis over the following three (3) years until November 12, 2022. In the event of a change of control of the Issuer, the option shall become vested in full. /S/ Adam Davey, Attorney-in-fact 2018-11-14