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*
YOSELOFF MARK LAWRENCE

(Last) (First) (Middle)
1106 PALMS AIRPORT DRIVE

(Street)
LAS VEGAS NV 89119

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
SHUFFLE MASTER INC [ SHFL ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
X Officer (give title below) Other (specify below)
CEO & Chairman
3. Date of Earliest Transaction (Month/Day/Year)
05/06/2004
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 05/06/2004 A 30,000 A $32.6 332,236(1) 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
Stock Options $32.6 05/06/2004 A 70,000 10/31/2005 05/05/2014 Common Stock 70,000 $32.6 70,000 D
Stock Options $2.3519(2) (3) 10/25/2008 Common Stock 18,750 18,750 D
Stock Options $2.9393(4) (3) 10/25/2008 Common Stock 7,019 7,019 D
Stock Options $2.5185(5) (3) 11/03/2009 Common Stock 24,138 24,138 D
Stock Options $6.6852(6) (3) 11/20/2010 Common Stock 21,438 21,438 D
Stock Options $7.9(7) (3) 09/18/2011 Common Stock 108,435 108,435 D
Stock Options $7.9(8) 09/19/2004 09/18/2011 Common Stock 67,343 67,343 D
Stock Options $7.9(9) 09/19/2004 09/18/2011 Common Stock 12,657 12,657 D
Stock Options $14.6067(10) (3) 11/04/2012 Common Stock 37,500 37,500 D
Stock Options $14.6067(10) 11/05/2004 11/04/2012 Common Stock 37,500 37,500 D
Stock Options $14.6067(11) 11/05/2005 11/04/2012 Common Stock 30,654 30,654 D
Stock Options $14.6067(11) 11/05/2006 11/04/2012 Common Stock 30,654 30,654 D
Stock Options $14.6067(12) 11/05/2005 11/04/2012 Common Stock 6,846 6,846 D
Stock Options $14.6067(12) 11/05/2006 11/04/2012 Common Stock 6,846 6,846 D
Stock Options $12.8067(13) (3) 03/11/2013 Common Stock 22,500 22,500 D
Stock Options $12.8067(13) 03/12/2005 03/11/2013 Common Stock 22,500 22,500 D
Stock Options $12.8067(13) 03/12/2006 03/11/2013 Common Stock 22,500 22,500 D
Stock Options $12.8067(14) 03/12/2007 03/11/2013 Common Stock 14,693 14,693 D
Stock Options $12.8067(15) 03/12/2007 03/11/2013 Common Stock 7,808 7,808 D
Stock Options $18.5(16) 10/23/2004 10/22/2013 Common Stock 22,500 22,500 D
Stock Options $18.5(16) 10/23/2005 10/22/2013 Common Stock 22,500 22,500 D
Stock Options $18.5(16) 10/23/2006 10/22/2013 Common Stock 22,500 22,500 D
Stock Options $18.5(16) 10/23/2007 10/22/2013 Common Stock 22,500 22,500 D
Stock Options $22.82(17) (18) 02/22/2014 Common Stock 247,500 247,500 D
Explanation of Responses:
1. On April 5, 2004, the common stock of the company split 3-for-2, resulting in the reporting person's acquisition of 101079 additional shares of common stock.
2. These options were previously reported as 12,500 shares at an exercise price of $3.5278, but was adjusted to reflect the split on April 5, 2004.
3. Currently exercisable.
4. These options were previously reported as 4,679 shares at an exercise price of $4.4089, but was adjusted to reflect the split on April 5, 2004.
5. These options were previously reported as 16,092 shares at an exercise price of $3.7778, but was adjusted to reflect the split on April 5, 2004.
6. These options were previously reported as 14,292 shares at an exercise price of $10.0278, but was adjusted to reflect the split on April 5, 2004.
7. These options were previously reported as 72,290 shares at an exercise price of $11.85, but was adjusted to reflect the split on April 5, 2004.
8. These options were previously reported as 44,895 shares at an exercise price of $11.85, but was adjusted to reflect the split on April 5, 2004.
9. These options were previously reported as 8,438 shares at an exercise price of $11.85, but was adjusted to reflect the split on April 5, 2004.
10. These options were previously reported as 25,000 shares at an exercise price of $21.91, but was adjusted to reflect the split on April 5, 2004.
11. These options were previously reported as 20,436 shares at an exercise price of $21.91, but was adjusted to reflect the split on April 5, 2004.
12. These options were previously reported as 4,564 shares at an exercise price of $21.91, but was adjusted to reflect the split on April 5, 2004.
13. These options were previously reported as 15,000 shares at an exercise price of $19.21, but was adjusted to reflect the split on April 5, 2004.
14. These options were previously reported as 9,795 shares at an exercise price of $19.21, but was adjusted to reflect the split on April 5, 2004.
15. These options were previously reported as 5,205 shares at an exercise price of $19.21, but was adjusted to reflect the split on April 5, 2004.
16. These options were previously reported as 15,000 shares at an exercise price of $27.75, but was adjusted to reflect the split on April 5, 2004.
17. These options were previously reported as 165,000 shares at an exercise price of $34.23, but was adjusted to reflect the split on April 5, 2004.
18. These options were previously reported as exercisable the earlier of certain target dates or when the company stock reaches a certain target price. The target price has now been reached, thus these options are now currently exercisable.
Jerome R. Smith, by Power of Attorney 05/07/2004
** 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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