0001209191-11-051519.txt : 20111012 0001209191-11-051519.hdr.sgml : 20111012 20111012134527 ACCESSION NUMBER: 0001209191-11-051519 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20110930 FILED AS OF DATE: 20111012 DATE AS OF CHANGE: 20111012 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: JONAS DAVID A CENTRAL INDEX KEY: 0001211654 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-18933 FILM NUMBER: 111137226 MAIL ADDRESS: STREET 1: C/O ROCHESTER MEDICAL INC STREET 2: ONE RCHESTER MEDICAL DRIVE CITY: STEWARTVILLE STATE: MN ZIP: 55976 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ROCHESTER MEDICAL CORPORATION CENTRAL INDEX KEY: 0000868368 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 411613227 STATE OF INCORPORATION: MN FISCAL YEAR END: 0930 BUSINESS ADDRESS: STREET 1: ONE ROCHESTER MEDICAL DR CITY: STEWARTVILLE STATE: MN ZIP: 55976 BUSINESS PHONE: 5075339600 MAIL ADDRESS: STREET 1: ONE ROCHESTER MEDICAL DR CITY: STEWARTVILLE STATE: MN ZIP: 55976 5 1 doc5.xml FORM 5 SUBMISSION X0304 5 2011-09-30 0 0 0 0000868368 ROCHESTER MEDICAL CORPORATION ROCM 0001211654 JONAS DAVID A ONE ROCHESTER MEDICAL DRIVE STEWARTVILLE MN 55976 1 1 0 0 CFO and Treasurer Common Stock 2011-09-15 5 W 0 1000 0.00 A 82500 D Includes restricted stock award shares. /s/ David A. Jonas 2011-10-12