0001179110-12-001974.txt : 20120207 0001179110-12-001974.hdr.sgml : 20120207 20120207164614 ACCESSION NUMBER: 0001179110-12-001974 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20111231 FILED AS OF DATE: 20120207 DATE AS OF CHANGE: 20120207 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Fain Eric S CENTRAL INDEX KEY: 0001402222 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-12441 FILM NUMBER: 12578424 MAIL ADDRESS: STREET 1: ONE ST JUDE MEDICAL DRIVE CITY: ST. PAUL STATE: MN ZIP: MN ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ST JUDE MEDICAL INC CENTRAL INDEX KEY: 0000203077 STANDARD INDUSTRIAL CLASSIFICATION: ELECTROMEDICAL & ELECTROTHERAPEUTIC APPARATUS [3845] IRS NUMBER: 411276891 STATE OF INCORPORATION: MN FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: ONE ST JUDE MEDICAL DRIVE CITY: ST PAUL STATE: MN ZIP: 55117 BUSINESS PHONE: 6517562000 MAIL ADDRESS: STREET 1: ONE ST JUDE MEDICAL DRIVE CITY: ST PAUL STATE: MN ZIP: 55117 5 1 edgar.xml FORM 5 - X0304 5 2011-12-31 0 0 0 0000203077 ST JUDE MEDICAL INC STJ 0001402222 Fain Eric S ONE ST. JUDE MEDICAL DRIVE ST. PAUL MN 55117 0 1 0 0 President, CRMD Common Stock 2011-12-23 5 G 0 300 0 D 71139 D Gift of 300 shares to Brown University. /s/ Kashif Rashid, Attorney in Fact 2012-02-07