0001181431-12-003221.txt : 20120119 0001181431-12-003221.hdr.sgml : 20120119 20120119195606 ACCESSION NUMBER: 0001181431-12-003221 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20120117 FILED AS OF DATE: 20120119 DATE AS OF CHANGE: 20120119 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: 12535660 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 rrd330912.xml KIMV VOLUNTARYFORM4 T1-17-12 X0304 4 2012-01-17 1 0000718789 SHUFFLE MASTER INC SHFL 0001494805 Vukanovich Kim 1106 PALMS AIRPORT DRIVE LAS VEGAS NV 89119 0 0 0 1 SVP Operation & Administration Restricted Stock Units 2012-01-17 4 A 0 7160 0 A 31408 D Stock Options 12.54 2012-01-17 4 A 0 3485 0 A 2013-01-17 2022-01-17 Common Stock 3485 3485 D Stock Options 12.54 2012-01-17 4 A 0 3485 0 A 2014-01-17 2022-01-17 Common Stock 3485 3485 D Stock Options 12.54 2012-01-17 4 A 0 3485 0 A 2015-01-17 2022-01-17 Common Stock 3485 3485 D Stock Options 12.54 2012-01-17 4 A 0 3485 0 A 2016-01-17 2022-01-17 Common Stock 3485 3485 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 2012-01-19