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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. | SEC 1474 (9-02) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) |
5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4, and 5) |
6. Date Exercisable and Expiration Date (Month/Day/Year) |
7. Title and Amount of Underlying Securities (Instr. 3 and 4) |
8. Price of Derivative Security (Instr. 5) |
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) |
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Restricted Stock Unit | (2) | 05/28/2008 | A | 2,000 | 05/27/2009(3) | (3) | Common Stock | 2,000 | (4) | 67,001 (1) | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
KOOLE A J MARTENSLINDESTRAAT 5, 6215 JP MAASTRICHT THE NETHERLANDS |
Controller |
Larry Bakeman | 05/30/2008 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 4(b)(v). |
** | Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
(1) | Includes 65,001 shares that Mr. Koole may acquire upon the exercise of options that are exercisable within 60 days of May 28, 2008. Also includes 2,000 restricted stock units which are eligible for dividend and voting equivalent rights. |
(2) | Each restricted stock unit represents a contingent right to receive one share of Uroplasty, Inc. common stock. |
(3) | The restricted stock units will vest on 5/27/2009 contingent upon continued employment through such date. |
(4) | Recipient did not pay cash or other consideration for the receipt of the restricted stock units. The closing share price of Uroplasty, Inc. common stock on the grant date was $3.15. |
Remarks: Signature is on behalf of Mr. Koole |