0001209191-12-029607.txt : 20120521
0001209191-12-029607.hdr.sgml : 20120521
20120521185209
ACCESSION NUMBER: 0001209191-12-029607
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20120520
FILED AS OF DATE: 20120521
DATE AS OF CHANGE: 20120521
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: SCHIRO JAMES J
CENTRAL INDEX KEY: 0001217164
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-54192
FILM NUMBER: 12860177
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: REVA Medical, Inc.
CENTRAL INDEX KEY: 0001496268
STANDARD INDUSTRIAL CLASSIFICATION: ORTHOPEDIC, PROSTHETIC & SURGICAL APPLIANCES & SUPPLIES [3842]
IRS NUMBER: 330810505
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 5751 COPLEY DRIVE
CITY: SAN DIEGO
STATE: CA
ZIP: 92111
BUSINESS PHONE: (858) 966-3000
MAIL ADDRESS:
STREET 1: 5751 COPLEY DRIVE
CITY: SAN DIEGO
STATE: CA
ZIP: 92111
4
1
doc4.xml
FORM 4 SUBMISSION
X0305
4
2012-05-20
0
0001496268
REVA Medical, Inc.
RVA:AX
0001217164
SCHIRO JAMES J
5751 COPLEY DRIVE
SAN DIEGO
CA
92111
1
0
0
0
Stock Option (Right to Buy)
6.52
2012-05-20
4
A
0
12500
0.00
A
2022-05-20
Common Stock
12500
12500
D
The option shares are immediately exercisable. 25% of the option shares vest on May 20, 2013 with the remaining option shares vesting in 36 equal monthly installments thereafter.
/s/ Katrina Thompson, Attorney-in-fact
2012-05-20