0001213900-19-026405.txt : 20191218
0001213900-19-026405.hdr.sgml : 20191218
20191218095330
ACCESSION NUMBER: 0001213900-19-026405
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20191216
FILED AS OF DATE: 20191218
DATE AS OF CHANGE: 20191218
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Moore Daniel Jeffrey
CENTRAL INDEX KEY: 0001400857
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-55195
FILM NUMBER: 191291498
MAIL ADDRESS:
STREET 1: 100 CYBERONICS BVLD
CITY: HOUSTON
STATE: TX
ZIP: 77058
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: 320 CONGRESS STREET
STREET 2: 3RD FLOOR
CITY: BOSTON
STATE: MA
ZIP: 02210
BUSINESS PHONE: 781-357-3310
MAIL ADDRESS:
STREET 1: 320 CONGRESS STREET
STREET 2: 3RD FLOOR
CITY: BOSTON
STATE: MA
ZIP: 02210
FORMER COMPANY:
FORMER CONFORMED NAME: GI DYNAMICS INC
DATE OF NAME CHANGE: 20030623
4
1
ownership.xml
X0306
4
2019-12-16
0
0001245791
GI DYNAMICS, INC.
GID
0001400857
Moore Daniel Jeffrey
320 CONGRESS STREET, FLOOR 3
BOSTON
MA
02210
1
0
0
0
Stock Option (right to buy)
1.34
2019-12-16
4
A
0
30000
0.00
A
2029-12-16
Common Stock
30000
30000
D
The stock option grant was approved by the Issuer's board of directors on October 29, 2019, subject to stockholder approval, and by the stockholders of the Issuer on December 16, 2019. The stock options will fully vest on October 29, 2020. In the event of a change of control of the Issuer prior to October 29, 2020, the stock options will become vested in full.
/s/ Daniel Jeffrey Moore
2019-12-17