-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, KcUxCGvBDu29LfXRMEp5yrM4fOI4UXVoQNPFT9SXHWrodbLZmzpDFKpsvgHYBD2d yQxAPjwbIAFR1bCl8+klJg== 0000910680-04-000577.txt : 20040602 0000910680-04-000577.hdr.sgml : 20040602 20040602162750 ACCESSION NUMBER: 0000910680-04-000577 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040505 FILED AS OF DATE: 20040602 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: MEDSOURCE TECHNOLOGIES INC CENTRAL INDEX KEY: 0001084726 STANDARD INDUSTRIAL CLASSIFICATION: WHOLESALE-MEDICAL, DENTAL & HOSPITAL EQUIPMENT & SUPPLIES [5047] IRS NUMBER: 522094496 BUSINESS ADDRESS: STREET 1: 110 CHESHIRE LANE CITY: MINNEAPOLIS STATE: MN ZIP: 55305 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: POLUMBO RALPH M CENTRAL INDEX KEY: 0001193974 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-49702 FILM NUMBER: 04844775 BUSINESS ADDRESS: STREET 1: C/O MEDSOURCE TECHNOLOGIES INC STREET 2: 110 CHESHIRE LANE STE 100 CITY: MINNEAPOLIS STATE: MN ZIP: 55305 4 1 f4polumbo-05052004_ex.xml MAY 5, 2004 X0202 4 2004-05-05 0 0001084726 MEDSOURCE TECHNOLOGIES INC MEDT 0001193974 POLUMBO RALPH M C/O MEDSOURCE TECHNOLOGIES INC 110 CHESHIRE LANE STE 100 MINNEAPOLIS MN 55305 0 1 0 0 Sr. VP-HR & Integration Common Stock 2004-05-05 4 A 0 475 4.335 A 95447 D The shares were issued pursuant to an Employee Stock Purchase Plan. /s/ Ralph M. Polumbo 2004-06-01 -----END PRIVACY-ENHANCED MESSAGE-----