SEC Form 4 · accession 0001140361-15-014853
CYBERONICS INC · LIVN
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Daniel Jeffrey Moore
Officer — President & CEO · Director
Period of report
Mar 15, 2015
Accepted (ET)
Apr 9, 2015 · 10:16 am EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000864683
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Mar 15, 2015 | F | 5,770 | — | D | 121,324 | D | |
| Common StockF2 | holding | — | — | — | 0 | I | Moore Family 2011 Gift Trust | |
| Common StockF3 | holding | — | — | — | 0 | I | Moore Family 2012 Gift Trust | |
| Common Stock | holding | — | — | — | 2,586 | I | DJM Family Partnership Ltd. | |
| Common Stock | holding | — | — | — | 14,560 | I | Grace M. Moore |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Phantom Stock UnitF4 | $65.26 | Mar 15, 2015 | M | 5,888 | A | — | Sep 15, 2021 | Phantom Stock Unit | 5,888 | 194,760 | D |
Explanation of responses
- F1The referenced shares were withheld from distribution at the request of Reporting Person. Such shares were forfeited and the associated value was used to offset the tax liability associated with the March 15, 2015 vesting of 19,113 shares of restricted stock.
- F2Beneficiaries of the Moore Family 2011 Gift Trust are Reporting Person's adult children, one of whom resided with Reporting Person until February 2015. Reporting Person no longer has a pecuniary interest in this trust.
- F3Beneficiaries of the Moore Family 2012 Gift Trust are Reporting Person's adult children, one of whom resided with Reporting Person until February 2015. Reporting Person no longer has a pecuniary interest in this trust.
- F4Reporting Person was granted an award of 23,551 Phantom Stock Units that vest as set forth in the Phantom Stock Agreement dated September 15, 2011. Subject to the Phantom Stock Agreement, the Phantom Stock Units may be settled in cash or shares of Cyberonics, Inc. common stock as determined by the Plan Administrator.