0001181431-11-061619.txt : 20111221 0001181431-11-061619.hdr.sgml : 20111221 20111221192841 ACCESSION NUMBER: 0001181431-11-061619 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20111219 FILED AS OF DATE: 20111221 DATE AS OF CHANGE: 20111221 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Vukanovich Kim CENTRAL INDEX KEY: 0001494805 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-20820 FILM NUMBER: 111275598 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 MAIL ADDRESS: STREET 1: 1106 PALMS AIRPORT DRIVE CITY: LAS VEGAS STATE: NV ZIP: 89119 4 1 rrd328821.xml FORM4 VOLUNTARY KIM T11-19-11 X0304 4 2011-12-19 1 0000718789 SHUFFLE MASTER INC SHFL 0001494805 Vukanovich Kim 1106 PALMS AIRPORT DRIVE LAS VEGAS NV 89119 0 0 0 1 SVP Operation & Administration Common Stock 2011-12-19 4 A 0 15948 0 A 24248 D The Reporting Person, who remains employed by the Issuer, has ceased to be a Reporting Person pursuant to Section 16 as of December 19,2011. Kathryn S. Lever, by Power of Attorney 2011-12-21