0001209191-12-051139.txt : 20121101 0001209191-12-051139.hdr.sgml : 20121101 20121101121314 ACCESSION NUMBER: 0001209191-12-051139 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20121031 FILED AS OF DATE: 20121101 DATE AS OF CHANGE: 20121101 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: 121172741 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 X0306 4 2012-10-31 0 0001013606 ENDOLOGIX INC /DE/ ELGX 0001491299 Wilder Thomas 1841 PORT SHEFFIELD PLACE NEWPORT BEACH CA 92660 1 0 0 0 Common Stock 2012-10-31 2012-10-31 4 M 0 10000 8.26 A 17102 D Common Stock 2012-10-31 2012-10-31 4 S 0 10000 13.56 D 7102 D Option to Purchase 8.26 2012-10-31 2012-10-31 4 M 0 10000 0.00 D 2012-05-25 2021-05-25 Common Stock 10000 10000 D Thomas C. Wilder by Robert J. Krist, Attorney-in-Fact for Reporting Person 2012-11-01