0001209191-11-035391.txt : 20110617 0001209191-11-035391.hdr.sgml : 20110617 20110617175834 ACCESSION NUMBER: 0001209191-11-035391 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20110615 FILED AS OF DATE: 20110617 DATE AS OF CHANGE: 20110617 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: DERY TERESA J CENTRAL INDEX KEY: 0001259886 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-20243 FILM NUMBER: 11919713 MAIL ADDRESS: STREET 1: 7700 FRABCE AVE SOUTH CITY: EDINA STATE: MN ZIP: 55435 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: VALUEVISION MEDIA INC CENTRAL INDEX KEY: 0000870826 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-CATALOG & MAIL-ORDER HOUSES [5961] IRS NUMBER: 411673770 STATE OF INCORPORATION: MN FISCAL YEAR END: 0130 BUSINESS ADDRESS: STREET 1: 6740 SHADY OAK RD CITY: MINNEAPOLIS STATE: MN ZIP: 55344-3433 BUSINESS PHONE: 6129475200 MAIL ADDRESS: STREET 1: 6740 SHADY OAK RAOD CITY: EDEN PRAIRIE STATE: MN ZIP: 55344-3433 FORMER COMPANY: FORMER CONFORMED NAME: VALUEVISION INTERNATIONAL INC DATE OF NAME CHANGE: 19930328 4 1 doc4.xml FORM 4 SUBMISSION X0303 4 2011-06-15 0 0000870826 VALUEVISION MEDIA INC VVTV 0001259886 DERY TERESA J 6740 SHADY OAK ROAD EDEN PRAIRIE MN 55344 0 1 0 0 Sr VP and General Counsel Common Stock (option to buy) 7.53 2011-06-15 4 A 0 100000 0.00 A 2021-06-15 Common Stock 100000 100000 D Options vest as to 33,333 shares of common stock on each of the first and second anniversary of the date of grant, and 33,334 shares of common stock on the third anniversary of the date of grant. /s/ Teresa J. Dery 2011-06-17