-----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, Udo0hQ8uMhJSTXDS9sa/ALs/e+hW/tlKwep6JLHiVl7EMsrJWVhAhGLWOJXnI6JC oj8gnj1Ifddum6eUl/512g== 0001209191-04-059100.txt : 20041222 0001209191-04-059100.hdr.sgml : 20041222 20041222140724 ACCESSION NUMBER: 0001209191-04-059100 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20041222 FILED AS OF DATE: 20041222 DATE AS OF CHANGE: 20041222 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: UROPLASTY INC CENTRAL INDEX KEY: 0000890846 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 411719250 STATE OF INCORPORATION: MN FISCAL YEAR END: 0331 BUSINESS ADDRESS: STREET 1: 2718 SUMMER STREET NE CITY: MINNEAPOLIS STATE: MN ZIP: 55413 BUSINESS PHONE: 6123781180 MAIL ADDRESS: STREET 1: 2718 SUMMER ST NE CITY: MINNEAPOLIS STATE: MN ZIP: 55413 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: HOLMAN DANIEL G CENTRAL INDEX KEY: 0001187884 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-20989 FILM NUMBER: 041220193 BUSINESS ADDRESS: STREET 1: 2718 SUMMER ST NE CITY: MINNEAPLIS STATE: MN ZIP: 55413 MAIL ADDRESS: STREET 1: 15512 BOULDER POINTE ROAD CITY: EDEN PRAIRIE STATE: MN ZIP: 55347 4 1 bmn90340_bmn2dgh.xml MAIN DOCUMENT DESCRIPTION X0202 4 2004-12-22 0000890846 UROPLASTY INC UPST 0001187884 HOLMAN DANIEL G 2718 SUMMER STREET NE MINNEAPOLIS MN 55413 1 1 0 0 President Stock Options (1) 5.30 2004-12-22 4 M 0 37500 5.30 A 2004-12-21 2009-12-21 Common Stock 37500 102616 I By Spouse Stock Options (1) 5.30 2004-12-22 4 M 0 37500 5.30 A 2005-12-21 2009-12-21 Common Stock 37500 140116 I By Spouse (1) These options are owned by reporting person's spouse. Reporting person disclaims any beneficial interests in these securities. Signature is on behalf of Daniel G. Holman /s/ Christie Reeves 2004-12-22 -----END PRIVACY-ENHANCED MESSAGE-----