0001181431-12-003225.txt : 20120119 0001181431-12-003225.hdr.sgml : 20120119 20120119195745 ACCESSION NUMBER: 0001181431-12-003225 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: LEVER KATHRYN S CENTRAL INDEX KEY: 0001338566 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-20820 FILM NUMBER: 12535668 MAIL ADDRESS: STREET 1: 3525 E POST ROAD CITY: LAS VEGAS STATE: NV ZIP: 89120 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 rrd330926.xml LEVER FORM4 T1-17-12 X0304 4 2012-01-17 0 0000718789 SHUFFLE MASTER INC SHFL 0001338566 LEVER KATHRYN S 1106 PALMS AIRPORT DRIVE LAS VEGAS NV 89119 0 0 0 1 General Counsel & EVP Restricted Stock Units 2012-01-17 4 A 0 10340 0 A 22400 D Stock Options 12.54 2012-01-17 4 A 0 5032 0 A 2013-01-17 2022-01-17 Common Stock 5032 5032 D Stock Options 12.54 2012-01-17 4 A 0 5033 0 A 2014-01-17 2022-01-17 Common Stock 5033 5033 D Stock Options 12.54 2012-01-17 4 A 0 5032 0 A 2015-01-17 2022-01-17 Common Stock 5032 5032 D Stock Options 12.54 2012-01-17 4 A 0 5033 0 A 2016-01-17 2022-01-17 Common Stock 5033 5033 D Each unit represents a right to convert into one share of common stock upon satisfaction of contingencies. Kathryn S. Lever 2012-01-19