Statement of Changes in Beneficial Ownership (4)
June 17 2015 - 6:19PM
Edgar (US Regulatory)
FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue.
See
Instruction 1(b).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0287
Estimated average burden
hours per response...
0.5
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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
*
Moore Daniel Jeffrey
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2. Issuer Name
and
Ticker or Trading Symbol
CYBERONICS INC
[
CYBX
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__
X
__ Director
_____ 10% Owner
__
X
__ Officer (give title below)
_____ Other (specify below)
President & CEO
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(Last)
(First)
(Middle)
100 CYBERONICS BLVD
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3. Date of Earliest Transaction
(MM/DD/YYYY)
6/15/2015
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(Street)
HOUSTON, TX 77058
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_
X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security
(Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code
(Instr. 8)
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4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Common Stock
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6/15/2015
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S
(1)
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2500
(2)
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D
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$61.3424
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113824
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D
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Common Stock
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6/15/2015
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F
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5781
(3)
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D
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$61.76
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108043
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D
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Common Stock
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6/15/2015
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F
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2436
(4)
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D
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$61.76
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105607
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D
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Common Stock
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6/15/2015
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F
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697
(5)
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D
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$61.76
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104910
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D
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Common Stock
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6/15/2015
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F
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1046
(6)
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D
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$61.76
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103864
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D
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Common Stock
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6/15/2015
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F
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559
(7)
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D
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$61.76
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103305
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D
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Common Stock
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6/15/2015
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D
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3326
(8)
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D
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$0.00
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99979
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D
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Common Stock
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6/15/2015
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D
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1663
(9)
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D
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$0.00
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98316
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D
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Common Stock
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2586
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I
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DJM Family Partnership
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Table II - Derivative Securities Beneficially Owned (
e.g.
, puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
(Instr. 3)
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2. Conversion or Exercise Price of Derivative Security
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3. Trans. Date
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3A. Deemed Execution Date, if any
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4. Trans. Code
(Instr. 8)
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5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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6. Date Exercisable and Expiration Date
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7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4)
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8. Price of Derivative Security
(Instr. 5)
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9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)
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10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4)
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11. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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(A)
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(D)
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Date Exercisable
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Expiration Date
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Title
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Amount or Number of Shares
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Phantom Stock Units
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$61.76
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6/15/2015
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M
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4587
(10)
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6/15/2015
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6/15/2015
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Common Stock
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4587
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(10)
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190173
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D
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Phantom Stock Units
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$61.76
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6/15/2015
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M
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6881
(11)
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6/15/2015
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6/15/2015
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Common Stock
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6881
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(11)
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183292
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D
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Phantom Stock Units
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$0
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6/15/2015
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D
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13763
(12)
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6/15/2015
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6/15/2015
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Common Stock
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13763
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$0.00
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169529
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D
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Explanation of Responses:
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(
1)
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Shares sold pursuant to a Rule 10b5-1 Plan.
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(
2)
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Represents weighted average selling price. Securities were sold through approximately 33 separate sales on the transaction date at prices ranging from $60.35 to $61.79. The reporting person hereby undertakes to provide upon request to the SEC, the issuer or any stockholder of the issuer, the full information regarding the number of shares and prices at which the transaction was effected.
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(
3)
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The 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 vesting of 13,781 shares of restricted stock.
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(
4)
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The 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 vesting of 5,808 shares of restricted stock.
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(
5)
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The 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 vesting of 1,663 shares of performance based restricted stock.
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(
6)
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The 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 vesting of 2,495 shares of performance based restricted stock.
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(
7)
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The 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 vesting of 1,333 shares of performance based restricted stock.
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(
8)
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Reporting Person did not meet specific performance goals in accordance with the terms of the Performance-Based Restricted Stock Agreement dated June 15, 2011. Therefore, subject restricted shares are forfeited prior to vesting in accordance with the terms of the Performance-Based Restricted Stock Agreement.
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(
9)
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Reporting Person did not meet specific performance goals in accordance with the terms of the Performance-Based Restricted Stock Agreement dated June 15, 2011. Therefore, subject restricted shares are forfeited prior to vesting in accordance with the terms of the Performance-Based Restricted Stock Agreement.
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(
10)
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Reporting Person was granted an award of Phantom Stock Units that vest, as earned, subject to the satisfaction of certain specified targets 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. Reporting Person settled the phantom stock units in cash.
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(
11)
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Reporting Person was granted an award of Phantom Stock Units that vest, as earned, subject to the satisfaction of certain specified targets 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. Reporting Person settled the phantom stock units in cash.
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(
12)
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Reporting Person did not meet specified targets as set forth in the Phantom Stock Agreement dated September 15, 2011. Therefore, subject Phantom Stock Units are being forfeited.
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Reporting Owners
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Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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Moore Daniel Jeffrey
100 CYBERONICS BLVD
HOUSTON, TX 77058
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X
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President & CEO
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Signatures
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/s/ Daniel J. Moore
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6/17/2015
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**
Signature of Reporting Person
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Date
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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*
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If the form is filed by more than one reporting person,
see
Instruction 4(b)(v).
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**
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Intentional misstatements or omissions of facts constitute Federal Criminal Violations.
See
18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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Note:
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File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure.
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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.
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