SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

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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1. Name and Address of Reporting Person*
Hoare Rohan

(Last) (First) (Middle)
5 MERCHANT SQUARE
NORTH WHARF ROAD

(Street)
LONDON X0 W2 1AY

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
10/19/2015
3. Issuer Name and Ticker or Trading Symbol
LivaNova PLC [ LIVN ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
President, Neuromodulation
5. 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 Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 7,505 D
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Option to purchase common stock 10/19/2015 09/15/2023 Common Stock 9,972 $51.53 D
Option to purchase common stock 10/19/2015 06/15/2024 Common Stock 18,968 $57.39 D
Option to purchase common stock (1) 10/19/2020 Common Stock 52,473 $69.39 D
Explanation of Responses:
1. Reporting Person was granted an award of stock appreciation rights ("SARs"). Subject to the terms and conditions of the SAR Agreement, the SARs shall vest in equal installments of 50% on each of the first two anniversaries of the grant date, October 19, 2015. Payment of such amount shall be in cash, shares (based on their Fair Market Value as of the date the SAR is exercised) or a combination of both, as determined by the Administrator.
Remarks:
Taylor Pollock, as POA 10/22/2015
** 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 5 (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).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.