-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, RLHWAWpIH/TEFJriPxiKK2PzBBmltivUBmCs2xfad4xiByKbDfGnuMk4tlj6var8 Yw2VKtCCGFiXpbLuIY9Hpg== 0001209191-04-051239.txt : 20041104 0001209191-04-051239.hdr.sgml : 20041104 20041104142853 ACCESSION NUMBER: 0001209191-04-051239 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20041102 FILED AS OF DATE: 20041104 DATE AS OF CHANGE: 20041104 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BOEHNEN DAVID L CENTRAL INDEX KEY: 0001214543 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-18602 FILM NUMBER: 041119226 BUSINESS ADDRESS: STREET 1: 11840 VALLEY VIEW ROAD CITY: EDEN PRAIRIE STATE: MN ZIP: 55344 BUSINESS PHONE: 9528284963 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ATS MEDICAL INC CENTRAL INDEX KEY: 0000824068 STANDARD INDUSTRIAL CLASSIFICATION: ORTHOPEDIC, PROSTHETIC & SURGICAL APPLIANCES & SUPPLIES [3842] IRS NUMBER: 411595629 STATE OF INCORPORATION: MN FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 3905 ANNAPOLIS LA STREET 2: SUITE 105 CITY: MINNEAPOLIS STATE: MN ZIP: 55447 BUSINESS PHONE: 6125537736 MAIL ADDRESS: STREET 1: 3905 ANNAPOLIS LANE STREET 2: SUITE 105 CITY: MINNEAPOLIS STATE: MN ZIP: 55447 FORMER COMPANY: FORMER CONFORMED NAME: ATS MEDCIAL INC DATE OF NAME CHANGE: 19920803 4 1 doc4.xml FORM 4 SUBMISSION X0202 4 2004-11-02 0 0000824068 ATS MEDICAL INC ATSI 0001214543 BOEHNEN DAVID L 71 OTIS LANE ST. PAUL MN 55104 1 0 0 0 Common Stock 64760 D Option (Right to Buy) 3.60 2004-11-02 4 A 0 7500 0.00 A 2005-11-02 2014-11-02 Common Stock 7500 7500 D Vests in 25% annual cumulative installments beginning this date. /s/ Deborah K. Chapman, Power of Attorney for David Boehnen 2004-11-04 -----END PRIVACY-ENHANCED MESSAGE-----