0001235802-15-000035.txt : 20150402
0001235802-15-000035.hdr.sgml : 20150402
20150402160336
ACCESSION NUMBER: 0001235802-15-000035
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 2
CONFORMED PERIOD OF REPORT: 20150331
FILED AS OF DATE: 20150402
DATE AS OF CHANGE: 20150402
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: UROPLASTY INC
CENTRAL INDEX KEY: 0000890846
STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841]
IRS NUMBER: 411719250
STATE OF INCORPORATION: MN
FISCAL YEAR END: 0331
BUSINESS ADDRESS:
STREET 1: 5420 FELTL ROAD
CITY: MINNETONKA
STATE: MN
ZIP: 55343
BUSINESS PHONE: (952) 426-6140
MAIL ADDRESS:
STREET 1: 5420 FELTL ROAD
CITY: MINNETONKA
STATE: MN
ZIP: 55343
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Hammers Darin
CENTRAL INDEX KEY: 0001570134
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-32632
FILM NUMBER: 15747458
MAIL ADDRESS:
STREET 1: 5420 FELTL RD
CITY: MINNETONKA
STATE: MN
ZIP: 55343
4
1
primary_doc.xml
PRIMARY DOCUMENT
X0306
4
2015-03-31
0
0000890846
UROPLASTY INC
UPI
0001570134
Hammers Darin
5420 FELTL RD
MINNETONKA
MN
55343
0
1
0
0
Sr VP Global Sales & Marketing
Common Stock
2015-03-31
4
D
0
131800
D
0
D
Stock Option (right to buy)
2.69
2015-03-31
4
D
0
100000
D
2020-02-10
Common Stock
100000
0
D
Consists of 33,333 shares subject to restricted stock assumed by Cogentix Medical, Inc., formerly Vision-Sciences, Inc. ("Cogentix") in the merger agreement between issuer and Cogentix and replaced with 24,219 shares of Cogentix stock valued at $4.09 per share, 75,000 shares subject to restricted stock assumed by Cogentix and replaced with 54,495 shares of Cogentix stock valued at $4.56 per share and 23,467 shares disposed of pursuant to the merger agreement in exchange for 17,052 shares of Cogentix common stock on the effective date of the merger.
This option, which provided for vesting in three almost equal annual installments beginning on February 11, 2014, was assumed by Cogentix in the merger and replaced with an option to purchase 72,661 shares of Cogentix stock for $3.71 per share.
/s/ Brett Reynolds, attorney-in-fact
2015-04-02
EX-99.1
2
poa-hammers.txt
POWER OF ATTORNEY
The undersigned hereby constitutes and appoints
Robert C. Kill and Brett Reynolds, and each of them
signing singly, and with full power of substituion,
to be the undersigned's true and lawful attorney-
in-fact to:
(1) Prepare, execute in the undersigned's name
and on the undersigned's behalf, and to submit to
the U.S. Securities and Exchange Commission
(the SEC) a Form ID, including amendments thereto,
and any other documents necessary or appropriate
to obtain codes and passwords enabling the
undersigned to make electronic filings with the
SEC of reports required by Section 16(a) of the
Securities Exchange Act of 1934, Rule 144 under the
Securities Act of 1933, or any rule or regulation
of the SEC; and
(2) Execute for and on behalf of the undersigned,
in the undersigned's capacity as a director of
Uroplasty, Inc., any Form 144 in accordance with Rule
144 under the Securities Act of 1933, as amended,
and any Form 3, Form 4 or Form 5 in accordance with
Section 16(a) of the Securities Exchange Act of 1934,
as amended, and the rules and regulations adopted
thereunder; and
(3) Do and perform any and all acts for and on
behalf of the undersigned which may be necessary
or desirable to complete and execute any such
Form 144, Form 3, Form 4 or Form 5, complete and
execute any amendment or amendments thereto, and
timely file such form with the SEC and any stock
exchange or similar authority; and
(4) Take any other action of any type
whatsoever in connection with the foregoing which,
in the opinion of such attorney-in-fact, may be
of benefit to, in the best interest of, or legally
required by, the undersigned, it being understood
that the documents executed by such attorney-in-fact
on behalf of the undersigned pursuant to this Power
of Attorney shall be in such form and shall contain
such terms and conditions as such attorney-in-fact
may approve in such attorney-in-fact's discretion.
The undersigned hereby grants to each such
attorney-in-fact full power and authority to
do and perform any and every act and thing whatsoever
requisite, necessary, or proper to be done in the
exercise of any of the rights and powers herein
granted, as fully to all intents and purposes as
the undersigned might or could do if personally
present, with full power of substitution or
revocation, hereby ratifying and confirming all
that such attorney-in-fact, or such attorney-in-
fact's substitute or substitutes, shall lawfully
do or cause to be done by virtue of this Power
of Attorney and the rights and powers herein
granted. The undersigned acknowledges that the
foregoing attorneys-in-fact, in serving in such
capacity at the request of the undersigned, are not
assuming, nor is Uroplasty, Inc. assuming, any of
the undersigned's responsibilities to comply with
Section 16 of the Securities Exchange Act of 1934,
as amended, or Form 144 of the Securities Act of
1933, as amended.
This Power of Attorney shall remain in full
force and effect until the undersigned is no longer
required to file Form 144s, Form 3s, Form 4s or
Form 5s with respect to the undersigned's holdings
of and transactions in securities issued by
Uroplasty, Inc., unless earlier revoked by the
undersigned in a signed writing delivered to the
foregoing attorneys-in-fact.
IN WITNESS WHEREOF, the undersigned has caused
this Power of Attorney to be executed effective as
of this 31st day of March, 2015.
/s/ Darin Hammers
Signature
Darin Hammers
Print Name