0001181431-12-003224.txt : 20120119 0001181431-12-003224.hdr.sgml : 20120119 20120119195721 ACCESSION NUMBER: 0001181431-12-003224 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: Lopez David CENTRAL INDEX KEY: 0001357624 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-20820 FILM NUMBER: 12535666 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 rrd330925.xml LOPEZ FORM4 T1-17-12 X0304 4 2012-01-17 0 0000718789 SHUFFLE MASTER INC SHFL 0001357624 Lopez David 1106 PALMS AIRPORT DRIVE LAS VEGAS NV 89119 1 0 0 1 Chief Operating Officer & EVP Restricted Stock Units 2012-01-17 4 A 0 13920 0 A 82358 D Stock Options 12.54 2012-01-17 4 A 0 6775 0 A 2013-01-17 2022-01-17 Common Stock 6775 6775 D Stock Options 12.54 2012-01-17 4 A 0 6775 0 A 2014-01-17 2022-01-17 Common Stock 6775 6775 D Stock Options 12.54 2012-01-17 4 A 0 6775 0 A 2015-01-17 2022-01-17 Common Stock 6775 6775 D Stock Options 12.54 2012-01-17 4 A 0 6775 0 A 2016-01-17 2022-01-17 Common Stock 6775 6775 D Each unit represents a right to convert into one share of common stock upon satisfaction of contingencies. Kathryn S. Lever, by Power of Attorney 2012-01-19