0000899243-19-024041.txt : 20190923 0000899243-19-024041.hdr.sgml : 20190923 20190923154252 ACCESSION NUMBER: 0000899243-19-024041 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190919 FILED AS OF DATE: 20190923 DATE AS OF CHANGE: 20190923 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: 191107966 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 2019-09-19 0 0001245791 GI DYNAMICS, INC. ASX:GID 0001670397 Schorer Scott 320 CONGRESS STREET, FLOOR 3 BOSTON MA 02210 0 1 0 0 President and CEO Stock Option (right to buy) 1.1204 2019-09-19 4 A 0 1083976 0.00 A 2029-09-19 Common Stock 1083976 1804576 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 grant date, and the remaining shares vesting in equal amounts on a quarterly basis over the following three (3) years of continuous service. In the event of a change of control of the Issuer, the option shall become vested in full. /s/ Scott Schorer 2019-09-23