0001209191-16-125726.txt : 20160603 0001209191-16-125726.hdr.sgml : 20160603 20160603171048 ACCESSION NUMBER: 0001209191-16-125726 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160601 FILED AS OF DATE: 20160603 DATE AS OF CHANGE: 20160603 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: HeartWare International, Inc. CENTRAL INDEX KEY: 0001389072 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 980498958 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 500 OLD CONNECTICUT PATH CITY: FRAMINGHAM STATE: MA ZIP: 01701 BUSINESS PHONE: 508-739-0873 MAIL ADDRESS: STREET 1: 500 OLD CONNECTICUT PATH CITY: FRAMINGHAM STATE: MA ZIP: 01701 FORMER COMPANY: FORMER CONFORMED NAME: HeartWare LTD DATE OF NAME CHANGE: 20070206 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Harrison Seth Loring CENTRAL INDEX KEY: 0001404955 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34256 FILM NUMBER: 161696622 MAIL ADDRESS: STREET 1: SUITE 4 LEVEL 46 STREET 2: 2 PARK STREET CITY: SIDNEY STATE: C3 ZIP: 2000 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2016-06-01 0 0001389072 HeartWare International, Inc. HTWR 0001404955 Harrison Seth Loring C/O APPLE TREE PARTNERS 821 BROADWAY, 5TH FLOOR NEW YORK NY 10003 1 0 0 0 Common Stock 2016-06-01 4 M 0 1000 0.00 A 133393 D Common Stock 14936 I See Footnote Common Stock 3500 I See Footnote Stock Option (right to buy) 29.01 2016-06-01 4 A 0 1000 0.00 A 2017-06-01 2026-06-01 Common Stock 1000 7000 D Restricted Stock Unit 2016-06-01 4 A 0 1000 0.00 A 2017-06-01 2017-06-01 Common Stock 1000 2250 D Restricted Stock Unit 2016-06-01 4 M 0 1000 0.00 D 2016-06-01 2016-06-01 Common Stock 1000 1250 D Represents shares held by Mr. Harrison's spouse, Ms. Ariane Harrison Represents shares held by Tortoise Foundation, a charitable foundation managed by the reporting person. The stock options become exercisable on June 1, 2017 subject to the reporting person's continuous service as a director of the Company through June 1, 2017. In addition, the stock options will immediately vest upon the occurrence of a change in control (as defined in the 2012 Incentive Award Plan) or upon the reporting person's death prior to settlement. Each restricted stock unit represents a contingent right to receive one share of the Company's common stock. The restricted stock units vest on June 1, 2017 subject to the reporting person's continuous service as a director of the Company through June 1, 2017. In addition, the restricted stock units will immediately vest upon the occurrence of a change in control (as defined in the 2012 Incentive Award Plan) or upon the reporting person's death prior to settlement. /s/ Larry Knopf as Attorney-in-Fact 2016-06-03