0000899243-19-024042.txt : 20190923
0000899243-19-024042.hdr.sgml : 20190923
20190923154307
ACCESSION NUMBER: 0000899243-19-024042
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: Carter Charles Ross
CENTRAL INDEX KEY: 0001779359
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-55195
FILM NUMBER: 191107970
MAIL ADDRESS:
STREET 1: C/O GI DYNAMICS, INC.
STREET 2: 745 ATLANTIC AVENUE
CITY: BOSTON
STATE: MA
ZIP: 02111
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
0001779359
Carter Charles Ross
320 CONGRESS STREET, FLOOR 3
BOSTON
MA
02210
0
1
0
0
CFO and Secretary
Stock Option (right to buy)
1.1204
2019-09-19
4
A
0
385226
0.00
A
2029-09-19
Common Stock
385226
385226
D
The option will vest over a four (4) year period, with one quarter (1/4) of the shares subject to the Option vesting on the one (1) year anniversary of the transaction date, and the remaining shares vesting on a quarterly basis over the following three (3) years of continuous service, provided that you are providing services to the Company as an employee or consultant on such vesting dates (no vesting will occur following the termination of employment or consulting services).
/s/ Charles R. Carter
2019-09-23