SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
DUNN BROOKE

(Last) (First) (Middle)
1106 PALMS AIRPORT DRIVE

(Street)
LAS VEGAS NV 89119

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
SHUFFLE MASTER INC [ SHFL ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
Officer (give title below) X Other (specify below)
Senior Vice President
3. Date of Earliest Transaction (Month/Day/Year)
09/20/2004
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 21,000(2) D
Common Stock 09/20/2004 M 125 A $2.5185 21,125 D
Common Stock 09/20/2004 S(1) 125 D $36 21,000 D
Common Stock 09/20/2004 M 322 A $6.6852 21,322 D
Common Stock 09/20/2004 S(1) 322 D $36 21,000 D
Common Stock 09/20/2004 M 13,167 A $6.6852 34,167 D
Common Stock 09/20/2004 S(1) 7,053 D $36 27,114 D
Common Stock 09/20/2004 S(1) 2,500 D $36.03 24,614 D
Common Stock 09/20/2004 S(1) 3,614 D $36.05 21,000 D
Common Stock 09/20/2004 M 18,386 A $7.9 39,386 D
Common Stock 09/20/2004 S(1) 6,386 D $36.05 33,000 D
Common Stock 09/20/2004 S(1) 3,000 D $36.1 30,000 D
Common Stock 09/20/2004 S(1) 4,000 D $36.13 26,000 D
Common Stock 09/20/2004 S(1) 2,000 D $36.14 24,000 D
Common Stock 09/20/2004 S(1) 3,000 D $36.16 21,000 D
Common Stock 150(18) I Son(19)
Common Stock 150(18) I Daughter(19)
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Stock Options $2.5185 11/04/2002 11/03/2009 Common Stock 13,125 13,125(3) D
Stock Options $2.5185 09/20/2004 M 125 11/04/2002 11/03/2009 Common Stock 125 $2.5185 13,000 D
Stock Options $6.6852 10/31/2002 11/20/2010 Common Stock 4,364 4,364(4) D
Stock Options $6.6852 09/20/2004 M 322 10/31/2002 11/20/2010 Common Stock 322 $6.6852 4,042 D
Stock Options $6.6852 10/31/2003 11/20/2010 Common Stock 14,958 14,958(5) D
Stock Options $6.6852 10/31/2003 11/20/2010 Common Stock 13,167 13,167(6) D
Stock Options $6.6852 09/20/2004 M 13,167 10/31/2003 11/20/2010 Common Stock 13,167 $6.6852 0 D
Stock Options $7.9 09/19/2002 09/18/2011 Common Stock 30,000 30,000(7) D
Stock Options $7.9 09/20/2004 M 18,386 09/19/2002 09/18/2011 Common Stock 18,386 $7.9 11,614 D
Stock Options $7.9 09/19/2003 09/18/2011 Common Stock 30,000 30,000(7) D
Stock Options $7.9 09/19/2004 09/18/2011 Common Stock 17,343 17,343(8) D
Stock Options $7.9 09/19/2004 09/18/2011 Common Stock 12,657 12,657(9) D
Stock Options $14.6067 11/05/2003 11/04/2012 Common Stock 9,375 9,375(10) D
Stock Options $14.6067 11/05/2004 11/04/2012 Common Stock 9,375 9,375(10) D
Stock Options $14.6067 11/05/2005 11/04/2012 Common Stock 2,529 2,529(11) D
Stock Options $14.6067 11/05/2006 11/04/2012 Common Stock 2,529 2,529(11) D
Stock Options $14.6067 11/05/2005 11/04/2012 Common Stock 6,846 6,846(12) D
Stock Options $14.6067 11/05/2006 11/04/2012 Common Stock 6,846 6,846(12) D
Stock Options $12.8067 03/12/2004 03/11/2013 Common Stock 7,500 7,500(13) D
Stock Options $12.8067 03/12/2005 03/11/2013 Common Stock 7,500 7,500(13) D
Stock Options $12.8067 03/12/2006 03/11/2013 Common Stock 7,500 7,500(13) D
Stock Options $12.8067 03/12/2007 03/11/2013 Common Stock 7,500 7,500(13) D
Stock Options $18.5 10/23/2004 10/22/2013 Common Stock 7,500 7,500(14) D
Stock Options $18.5 10/23/2005 10/22/2013 Common Stock 7,500 7,500(14) D
Stock Options $18.5 10/23/2006 10/22/2013 Common Stock 7,500 7,500(14) D
Stock Options $18.5 10/23/2007 10/22/2013 Common Stock 7,287 7,287(15) D
Stock Options $18.5 10/23/2007 10/22/2013 Common Stock 213 213(16) D
Stock Options $28.1267 10/31/2005 03/15/2014 Common Stock 30,000 30,000(17) D
Explanation of Responses:
1. All sales are made pursuant to Stock Sales Plan, dated June 18, 2004, entered into pursuant to the requirement of Rule 10b5-1, adopted pursuant to the Securities Exchange Act of 1934, as amended.
2. These shares were previously reported as 14,200 shares, but were adjusted to reflect the split to shareholders of record as of April 5, 2004.
3. These options were previously reported as 8750 shares at an exercise price of $3.7778, but were adjusted to reflect the split to shareholders of record as of April 5, 2004.
4. These options were previously reported as 2,909 shares at an exercise price of $10.0278, but were adjusted to reflect the split to shareholders of record as of April 5, 2004.
5. These options were previously reported as 9,972 shares at an exercise price of $10.0278, but were adjusted to reflect the split to shareholders of record as of April 5, 2004.
6. These options were previously reported as 8,778 shares at an exercise price of $10.0278, but were adjusted to reflect the split to shareholders of record as of April 5, 2004.
7. These options were previously reported as 20,000 shares at an exercise price of $11.8500, but were adjusted to reflect the split to shareholders of record as of April 5, 2004.
8. These options were previously reported as 11,562 shares at an exercise price of $11.8500, but were adjusted to reflect the split to shareholders of record as of April 5, 2004.
9. These options were previously reported as 8,438 shares at an exercise price of $11.8500, but were adjusted to reflect the split to shareholders of record as of April 5, 2004.
10. These options were previously reported as 6,250 shares at an exercise price of $21.9101, but were adjusted to reflect the split to shareholders of record as of April 5, 2004.
11. These options were previously reported as 1,686 shares at an exercise price of $21.9101, but were adjusted to reflect the split to shareholders of record as of April 5, 2004.
12. These options were previously reported as 4,564 shares at an exercise price of $21.9101, but were adjusted to reflect the split to shareholders of record as of April 5, 2004.
13. These options were previously reported as 5,000 shares at an exercise price of $19.2101, but were adjusted to reflect the split to shareholders of record as of April 5, 2004.
14. These options were previously reported as 5,000 shares at an exercise price of $27.7500, but were adjusted to reflect the split to shareholders of record as of April 5, 2004.
15. These options were previously reported as 4,858 shares at an exercise price of $27.7500, but were adjusted to reflect the split to shareholders of record as of April 5, 2004.
16. These options were previously reported as 142 shares at an exercise price of $27.7500, but were adjusted to reflect the split to shareholders of record as of April 5, 2004.
17. These options were previously reported as 20,000 shares at an exercise price of $42.1901, but were adjusted to reflect the split to shareholders of record as of April 5, 2004.
18. These shares were previously reported as 100 shares, but was adjusted to reflect the split on April 5, 2004.
19. The reporting person expressly disclaims beneficial ownership.
Jerome R. Smith, by Power of Attorney 09/20/2004
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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