SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
SIMON JOHN

(Last) (First) (Middle)
711 FIFTH AVE

(Street)
NEW YORK NY 10022

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
CARDICA INC [ CRDC ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
02/08/2006
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 02/08/2006 C 35,430 A $0 35,430 D
Common Stock 02/08/2006 C 44,512 A $0 79,942 D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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 Securities Underlying Derivative Security (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: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Series C Preferred Stock $0 02/08/2006 C 35,430 02/08/2006 (1) Common Stock 35,430 $0 0 D(2)(3)
Series D Preferred Stock $0 02/08/2006 C 44,512 02/08/2006 (1) Common Stock 44,512 $0 0 D(2)(3)
Explanation of Responses:
1. Each share of Issuer's Series C Preferred Stock and Series D Preferred Stock has been automatically converted into one share of Issuer's Common Stock upon the closing of Issuer's initial public offering.
2. Excludes 23,808 shares of Series C Preferred Stock owned by the Reporting Person's adult children. The Reporting Person disclaims personal beneficial ownership, voting or dispositive powers over such shares.
3. The Reporting Person served as a managing director of Allen & Company Incorporated ("ACI"), the owner of record of 57,445 shares of Series C Preferred Stock and 166,692 shares of Series D Preferred Stock which was converted into Issuer's Common Stock upon the Issuer's initial public offering. The Reporting Person, by virtue of his service with ACI, may be deemed to be able to influence the voting and dispositive powers with respect to the shares held by ACI, but the Reporting Person disclaims any personal beneficial ownership of such shares. The Reporting Person disclaims any personal beneficial ownership in shares of Issuer's stock owned by any person that may be deemed affiliated with Allen & Company.
/s/ John Simon 02/10/2006
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* 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).
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