0001209191-15-044285.txt : 20150519
0001209191-15-044285.hdr.sgml : 20150519
20150519140551
ACCESSION NUMBER: 0001209191-15-044285
CONFORMED SUBMISSION TYPE: 4/A
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20150505
FILED AS OF DATE: 20150519
DATE AS OF CHANGE: 20150519
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Halyard Health, Inc.
CENTRAL INDEX KEY: 0001606498
STANDARD INDUSTRIAL CLASSIFICATION: ORTHOPEDIC, PROSTHETIC & SURGICAL APPLIANCES & SUPPLIES [3842]
IRS NUMBER: 464987888
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 5405 WINDWARD PARKWAY
CITY: ALPHARETTA
STATE: GA
ZIP: 30004
BUSINESS PHONE: 678-425-9273
MAIL ADDRESS:
STREET 1: 5405 WINDWARD PARKWAY
CITY: ALPHARETTA
STATE: GA
ZIP: 30004
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Negro Renato
CENTRAL INDEX KEY: 0001624125
FILING VALUES:
FORM TYPE: 4/A
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36440
FILM NUMBER: 15875917
MAIL ADDRESS:
STREET 1: 351 PHELPS DRIVE
CITY: IRVING
STATE: TX
ZIP: 75038
4/A
1
doc4a.xml
FORM 4/A SUBMISSION
X0306
4/A
2015-05-05
2015-05-07
0
0001606498
Halyard Health, Inc.
HYH
0001624125
Negro Renato
5405 WINDWARD PARKWAY
ALPHARETTA
GA
30004
0
1
0
0
Vice President and Controller
Common Stock, $0.01 par value
2015-05-05
4
A
0
686
0.00
A
784
D
Common Stock, $0.01 par value
2015-05-05
4
A
0
1450
0.00
A
2234
D
Common Stock, $0.01 par value
2015-05-05
4
F
0
544
45.53
D
1690
D
Common Stock, $0.01 par value
2015-05-05
4
A
0
824
0.00
A
2514
D
Common Stock, $0.01 par value
2015-05-05
4
F
0
137
45.53
D
2377
D
Common Stock, $0.01 par value
2015-05-05
4
A
0
1288
0.00
A
3665
D
Common Stock, $0.01 par value
2015-05-05
4
F
0
150
45.53
D
3515
D
Common Stock, $0.01 par value
2015-05-05
4
A
0
1095
0.00
A
4610
D
Common Stock, $0.01 par value
2015-05-05
4
F
0
356
45.53
D
4254
D
Common Stock, $0.01 par value
2015-05-05
4
A
0
887
0.00
A
5141
D
Common Stock, $0.01 par value
2015-05-05
4
A
0
1816
0.00
A
6957
D
Represents time-vested restricted stock units issued pursuant to the Halyard Health Equity Participation Plan which will vest on May 5, 2018, subject to earlier vesting in the event of death, disability or certain other events.
On the initial Form 4, the amount listed in Item 5 did not include 98 shares of stock that the Reporting Person owned, and, among other things, this amendment is being filed to correct the beneficial ownership amount held by the Reporting Person following this transaction.
Represents time-vested restricted stock units issued pursuant to the Halyard Health, Inc. Equity Participation Plan which will vest immediately.
This transaction represents the withholding of 544 shares of common stock to satisfy the tax withholding obligations incurred by the Reporting Person upon the vesting of 1,450 shares of common stock awarded to the Reporting Person on May 5, 2015. The initial Form 4 incorrectly reflected the shares withheld for taxes as 484 shares.
Represents time-vested restricted stock issued pursuant to the Halyard Health Equity Participation Plan of which 354 shares will vest immediately and 470 will vest on May 1, 2016.
This transaction represents the withholding of 137 shares of common stock to satisfy the tax withholding obligations incurred by the Reporting Person upon the vesting of 354 shares of common stock awarded to the Reporting Person on May 5, 2015. The initial Form 4 incorrectly reflected the shares withheld for taxes as 118 shares.
Represents time-vested restricted stock units of which 386 of the awards will vest immediately, 386 of the awards will vest on May 1, 2016, and 516 of the awards will vest on May 1, 2017, subject to earlier vesting in the event of death, disability or other certain events.
This transaction represents the withholding of 150 shares of common stock to satisfy the tax withholding obligations incurred by the Reporting Person upon the vesting of 386 shares of common stock awarded to the Reporting Person on May 5, 2015. The initial Form 4 incorrectly reflected the shares withheld for taxes as 129 shares.
This transaction represents the withholding of 356 shares of common stock to satisfy the tax withholding obligations incurred by the Reporting Person upon the vesting of 1,095 shares of common stock awarded to the Reporting Person on May 5, 2015. The original Form 4 incorrectly reflected the shares withheld for taxes as 365 shares.
Represents time-vested restricted stock units issued pursuant to the Halyard Health, Inc. Equity Participation Plan which will vest on May 1, 2016, subject to earlier vesting in the event of death, disability or certain other events.
Represents time-vested restricted stock units issued pursuant to the Halyard Health, Inc. Equity Participation Plan which will vest on May 1, 2017, subject to earlier vesting in the event of death, disability or certain other events.
This Form 4A amends Table I of the Form 4 filed on May 7, 2015, in its entirety.
/s/ S. Ross Mansbach, Attorney-in-Fact for Renato Negro
2015-05-19