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