0001209191-11-060123.txt : 20111207 0001209191-11-060123.hdr.sgml : 20111207 20111207182529 ACCESSION NUMBER: 0001209191-11-060123 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20111205 FILED AS OF DATE: 20111207 DATE AS OF CHANGE: 20111207 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Wilder Thomas CENTRAL INDEX KEY: 0001491299 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-28440 FILM NUMBER: 111249566 MAIL ADDRESS: STREET 1: 1841 PORT SHEFFIELD PLACE CITY: NEWPORT BEACH STATE: CA ZIP: 92660 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ENDOLOGIX INC /DE/ CENTRAL INDEX KEY: 0001013606 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 680328265 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 11 STUDEBAKER CITY: IRVINE STATE: CA ZIP: 92618 BUSINESS PHONE: 9495957200 MAIL ADDRESS: STREET 1: 11 STUDEBAKER CITY: IRVINE STATE: CA ZIP: 92618 FORMER COMPANY: FORMER CONFORMED NAME: RADIANCE MEDICAL SYSTEMS INC /DE/ DATE OF NAME CHANGE: 19990122 FORMER COMPANY: FORMER CONFORMED NAME: CARDIOVASCULAR DYNAMICS INC DATE OF NAME CHANGE: 19960506 4 1 doc4.xml FORM 4 SUBMISSION X0304 4 2011-12-05 0 0001013606 ENDOLOGIX INC /DE/ ELGX 0001491299 Wilder Thomas 1841 PORT SHEFFIELD PLACE NEWPORT BEACH CA 92660 1 0 0 0 Common Stock 2011-12-05 2011-12-05 4 M 0 12500 4.36 A 12500 D Common Stock 2011-12-05 2011-12-05 4 S 0 12500 11.49 D 0 D Option to purchase 4.36 2011-12-05 4 M 0 12500 0.00 D 2011-05-20 2020-05-20 Common Stock 12500 37500 D Thomas C. Wilder III by Robert J. Krist, Attorney-in-Fact for Reporting Person 2011-12-07