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*
Moore Daniel Jeffrey

(Last) (First) (Middle)
100 CYBERONICS BLVD

(Street)
HOUSTON TX 77058

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
CYBERONICS INC [ CYBX ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
X Officer (give title below) Other (specify below)
President & CEO
3. Date of Earliest Transaction (Month/Day/Year)
03/15/2015
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 03/15/2015 F 5,770 D (1) 121,324 D
Common Stock 0(2) I Moore Family 2011 Gift Trust
Common Stock 0(3) I Moore Family 2012 Gift Trust
Common Stock 2,586 I DJM Family Partnership Ltd.
Common Stock 14,560 I Grace M. Moore
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
Phantom Stock Unit $65.26 03/15/2015 M 5,888 (4) 09/15/2021 Phantom Stock Unit 5,888 $0.00 194,760 D
Explanation of Responses:
1. The referenced shares were withheld from distribution at the request of Reporting Person. Such shares were forfeited and the associated value was used to offset the tax liability associated with the March 15, 2015 vesting of 19,113 shares of restricted stock.
2. Beneficiaries of the Moore Family 2011 Gift Trust are Reporting Person's adult children, one of whom resided with Reporting Person until February 2015. Reporting Person no longer has a pecuniary interest in this trust.
3. Beneficiaries of the Moore Family 2012 Gift Trust are Reporting Person's adult children, one of whom resided with Reporting Person until February 2015. Reporting Person no longer has a pecuniary interest in this trust.
4. Reporting Person was granted an award of 23,551 Phantom Stock Units that vest as set forth in the Phantom Stock Agreement dated September 15, 2011. Subject to the Phantom Stock Agreement, the Phantom Stock Units may be settled in cash or shares of Cyberonics, Inc. common stock as determined by the Plan Administrator.
Remarks:
Daniel J. Moore 04/09/2015
** 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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