-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, GL9nppk8q6lHh6FSrIWKRGktYwQUbCoLnxVGuQovgcoJiNnf86rRtzb+jS/B/1MI Y8Gwgi9NqgSWuxx3J9GRUg== 0001179110-04-010035.txt : 20040510 0001179110-04-010035.hdr.sgml : 20040510 20040510181958 ACCESSION NUMBER: 0001179110-04-010035 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040506 FILED AS OF DATE: 20040510 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SMITH JEROME R CENTRAL INDEX KEY: 0001285105 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-20820 FILM NUMBER: 04794532 MAIL ADDRESS: STREET 1: 1106 PALMS AIRPORT DRIVE CITY: LAS VEGAS STATE: NV ZIP: 89119 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: SHUFFLE MASTER INC CENTRAL INDEX KEY: 0000718789 STANDARD INDUSTRIAL CLASSIFICATION: MISCELLANEOUS MANUFACTURING INDUSTRIES [3990] IRS NUMBER: 411448495 STATE OF INCORPORATION: MN FISCAL YEAR END: 1031 BUSINESS ADDRESS: STREET 1: 1106 PALMS AIRPORT DRIVE CITY: LAS VEGAS STATE: NV ZIP: 89119 BUSINESS PHONE: 7028977150 4 1 edgar.xml FORM 4 - X0202 4 2004-05-06 0 0000718789 SHUFFLE MASTER INC SHFL 0001285105 SMITH JEROME R 1106 PALMS AIRPORT DRIVE LAS VEGAS NV 89119 0 0 0 1 Senior VP and General Counsel Common Stock 2004-05-06 4 A 0 10000 32.6 A 11500 D Stock Options 9.4725 2011-03-21 Common Stock 3750 3750 D Stock Options 12.0667 2011-08-21 Common Stock 1 1 D Stock Options 12.0667 2004-08-22 2011-08-21 Common Stock 5000 5000 D Stock Options 7.9 2011-09-18 Common Stock 19474 19474 D Stock Options 7.9 2004-09-19 2011-09-18 Common Stock 19475 19475 D Stock Options 7.9 2011-09-18 Common Stock 527 527 D Stock Options 7.9 2004-09-19 2011-09-18 Common Stock 525 525 D Stock Options 14.6067 2012-11-04 Common Stock 13125 13125 D Stock Options 14.6067 2004-11-05 2012-11-04 Common Stock 13125 13125 D Stock Options 14.6067 2005-11-05 2012-11-04 Common Stock 6279 6279 D Stock Options 14.6067 2006-11-05 2012-11-04 Common Stock 6279 6279 D Stock Options 14.6067 2005-11-05 2012-11-04 Common Stock 6846 6846 D Stock Options 14.6067 2006-11-05 2012-11-04 Common Stock 6846 6846 D Stock Options 12.8067 2013-03-11 Common Stock 3750 3750 D Stock Options 12.8067 2005-03-12 2013-03-11 Common Stock 3750 3750 D Stock Options 12.8067 2006-03-12 2013-03-11 Common Stock 3750 3750 D Stock Options 12.8067 2007-03-12 2013-03-11 Common Stock 3750 3750 D Stock Options 18.5 2004-10-23 2013-10-22 Common Stock 5625 5625 D Stock Options 18.5 2005-10-23 2013-10-22 Common Stock 5625 5625 D Stock Options 18.5 2006-10-23 2013-10-22 Common Stock 5625 5625 D Stock Options 18.5 2007-10-23 2013-10-22 Common Stock 2817 2817 D Stock Options 18.5 2007-10-23 2013-10-22 Common Stock 2808 2808 D On April 5, 2004, the common stock of the company split 3-for-2, resulting in the reporting person's acquiring of 500 additional shares of common stock. These options were previously reported as 2,500 shares at an exercise price of $14.2087, but was adjusted to reflect the split on April 5, 2004. Currently exercisable. This option was previously reported as 1 share at an exercise price of $18.10, but was adjusted to reflect the split on April 5, 2004. These options were previously reported as 3,333 shares at an exercise price of $18.10, but was adjusted to reflect the split on April 5, 2004. These options were previously reported as 12,983 shares at an exercise price of $11.85, but was adjusted to reflect the split on April 5, 2004. These options were previously reported as 351 shares at an exercise price of $11.85, but was adjusted to reflect the split on April 5, 2004. These options were previously reported as 350 shares at an exercise price of $11.85, but was adjusted to reflect the split on April 5, 2004. These options were previously reported as 8,750 shares at an exercise price of $21.91. but was adjusted to reflect the split on April 5, 2004. These options were previously reported as 4,186 shares at an exercise price of $21.91, but was adjusted to reflect the split on April 5, 2004. These options were previously reported as 4,564 shares at an exercise price of $21.91, but was adjusted to reflect the split on April 5, 2004. These options were previously reported as 2,500 shares at an exercise price of $19.21, but was adjusted to reflect the split on April 5, 2004. These options were previously reported as 3,750 shares at an exercise price of $27.75, but was adjusted to reflect the split on April 5, 2004. These options were previously reported as 1,878 shares at an exercise price of $27.75, but was adjusted to reflect the split on April 5, 2004. These options were previously reported as 1,872 shares at an exercise price of $27.75, but was adjusted to reflect the split on April 5, 2004. Jerome R. Smith, Esq. 2004-05-07 -----END PRIVACY-ENHANCED MESSAGE-----