0000914190-12-000633.txt : 20121213 0000914190-12-000633.hdr.sgml : 20121213 20121213105559 ACCESSION NUMBER: 0000914190-12-000633 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20121211 FILED AS OF DATE: 20121213 DATE AS OF CHANGE: 20121213 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SKARVAN KATHLEEN CENTRAL INDEX KEY: 0001266296 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34839 FILM NUMBER: 121261264 MAIL ADDRESS: STREET 1: 40 WEST HIGHLAND PARK DR NE CITY: HUTCHINSON STATE: MN ZIP: 55350 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Electromed, Inc. CENTRAL INDEX KEY: 0001488917 STANDARD INDUSTRIAL CLASSIFICATION: ELECTROMEDICAL & ELECTROTHERAPEUTIC APPARATUS [3845] IRS NUMBER: 411732920 FISCAL YEAR END: 0630 BUSINESS ADDRESS: STREET 1: 500 SIXTH AVENUE NW CITY: NEW PRAGUE STATE: MN ZIP: 56071 BUSINESS PHONE: 952-758-9299 MAIL ADDRESS: STREET 1: 500 SIXTH AVENUE NW CITY: NEW PRAGUE STATE: MN ZIP: 56071 4 1 edgar.xml PRIMARY DOCUMENT X0306 4 2012-12-11 0001488917 Electromed, Inc. ELMD 0001266296 SKARVAN KATHLEEN C/O ELECTROMED, INC. 500 SIXTH STREET NW NEW PRAGUE MN 56071 0 1 0 0 Chief Executive Officer Common Stock 2012-12-11 4 P 0 7000 1.41 A 7000 D Stock Options (Right to Buy) 1.75 2022-12-02 Common Stock 20000 20000 D 6,667 shares vest on 6/30/13 and 6/30/14 and 6,666 shares vest on 6/30/15. Scott J. Dorfman as Attorney-in-Fact for Kathleen Skarvan pursuant to Power of Attorney filed herewith. 2012-12-13 EX-24 2 skarvanpoa.htm SKARVAN POWER OF ATTORNEY

POWER OF ATTORNEY





 The undersigned hereby constitutes and appoints Jeremy Brock, Ryan

Brauer and Scott Dorfman, or either of them acting alone, the undersigned's

true and lawful attorney-in-fact and agent with full power of substitution

and resubstitution, for the undersigned and in the undersigned's name, place

and stead, in any and all capacities, to sign any or all Forms 3, Forms 4 and

Forms 5 relating to beneficial ownership of securities of Electromed, Inc.

(the "Issuer"), to file the same, with all exhibits thereto and other

documents in connection therewith, with the Securities and Exchange

Commission and to deliver a copy of the same to the Issuer, granting unto

said attorney-in-fact and agent full power and authority to do and perform

each and every act and thing requisite and necessary to be done in and about

the premises, as fully to all intents and purposes as the undersigned might

or could do in person, hereby ratifying and confirming all said attorney-in-

fact and agent, or his substitute or substitutes, may lawfully do or cause to

be done by virtue thereof.  The undersigned acknowledges that the foregoing

attorney-in-fact, in serving in such capacity at the request of the

undersigned, is not assuming any of the undersigned's responsibilities to

comply with Section 16 of the Securities Exchange Act of 1934.



 This power of attorney may be revoked as to any attorney-in-fact upon

written notice to that person, which shall be deemed to have been given if

mailed or if transmitted and confirmed by any standard form of

telecommunication, including but not limited to confirmed facsimile and email

transmissions.  Furthermore, this Power of Attorney will be terminated if at

any time the undersigned is no longer subject to the provisions of Section 16

of the Securities Exchange Act of 1934 with respect to securities of the

Issuer.



 IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney

to be executed as of this 4th day of December, 2012.



       /s/ Kathleen Skarvan



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