0001181431-11-042908.txt : 20110728 0001181431-11-042908.hdr.sgml : 20110728 20110728203320 ACCESSION NUMBER: 0001181431-11-042908 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20110726 FILED AS OF DATE: 20110728 DATE AS OF CHANGE: 20110728 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Jackson Michael C CENTRAL INDEX KEY: 0001366347 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33092 FILM NUMBER: 11995101 MAIL ADDRESS: STREET 1: HOUSATONIC PARTNERS STREET 2: 111 HUNTINGTON AVENUE, SUITE 2850 CITY: BOSTON STATE: MA ZIP: 02199 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: LEMAITRE VASCULAR INC CENTRAL INDEX KEY: 0001158895 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 000000000 BUSINESS ADDRESS: STREET 1: 63 2ND AVE CITY: BURLINGTON STATE: MA ZIP: 01803 BUSINESS PHONE: 781-221-2266 MAIL ADDRESS: STREET 1: 63 2ND AVE CITY: BURLINGTON STATE: MA ZIP: 01803 4 1 rrd318636.xml JACKSON FORM 4 11-07-28 X0303 4 2011-07-26 0 0001158895 LEMAITRE VASCULAR INC LMAT 0001366347 Jackson Michael C C/O LEMAITRE VASCULAR, INC. 63 SECOND AVENUE BURLINGTON MA 01803 1 0 0 0 Stock Option (Right to Buy) 7.10 2011-07-26 4 A 0 15000 0 A 2011-07-26 2016-07-26 Common Stock 15000 15000 I See Footnote This option is exercisable and vests over a three-year period at a rate of 33 1/3% on the anniversary of the date listed in the table, with the balance vesting in equal annual installments over the remaining two years. These options shall continue to vest as described above to the extent that a representative of Housatonic Equity Investors, L.P. continues to perform services for the Company. These securities are held by Housatonic Equity Investors, L.P. Housatonic Equity Partners I, LLC is the sole general partner of Housatonic Equity Investors, L.P., and Michael C. Jackson is a managing member of Housatonic Equity Partners I, LLC. As such, the reporting person may be deemed to share voting and investment power with respect to the securities held of record by Housatonic Equity Investors, L.P. The reporting person disclaims beneficial ownership of such securities except to the extent of his pecuniary interest therein, if any, and the reporting therein of such securities shall not be construed as an admission of beneficial ownership thereof for purposes of Section 16 or for any other purpose. /s/ Aaron M. Grossman Attorney-in-Fact 2011-07-28