SEC Form 4 · accession 0000914190-16-000807
Cardiovascular Systems Inc · CSII
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Paul A. Koehn
Officer — SVP Manufacturing & Operations
Period of report
Aug 26, 2016
Accepted (ET)
Aug 30, 2016 · 4:29 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001180145
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Aug 26, 2016 | D | 20,835 | $0.00 | D | 79,290 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock Option (right to buy)F2 | $8.83 | holding | — | — | — | — | Apr 17, 2017 | Common Stock | 35,585 | 35,585 | D |
| Stock Option (right to buy)F2 | $8.83 | holding | — | — | — | — | Apr 17, 2017 | Common Stock | 1,294 | 1,294 | D |
| Stock Option (right to buy)F2 | $7.90 | holding | — | — | — | — | Jun 11, 2017 | Common Stock | 8,087 | 8,087 | D |
| Stock Option (right to buy)F2 | $7.90 | holding | — | — | — | — | Oct 8, 2017 | Common Stock | 12,940 | 12,940 | D |
| Stock Option (right to buy)F2 | $12.15 | holding | — | — | — | — | Dec 11, 2017 | Common Stock | 32,350 | 32,350 | D |
| Stock Option (right to buy)F2 | $8.75 | holding | — | — | — | — | Mar 1, 2019 | Common Stock | 8,087 | 8,087 | D |
Explanation of responses
- F1Represents shares of restricted stock granted in August 2015 that have been forfeited based on performance achieved for total shareholder return and annual revenue growth for fiscal 2016 versus the Company's peer group.
- F2Fully exercisable.