X0303 4 2011-02-11 0 0001114200 AMERICAN MEDICAL SYSTEMS HOLDINGS INC AMMD 0001469660 Rasmussen Thomas K 10700 BREN ROAD WEST MINNETONKA MN 55343 0 1 0 0 VP Mtka Op & Global Supply Chn Common Stock 2011-02-11 4 A 0 3770 0 A 15863.761 D Non-Qualified Stock Option (right to buy) 20.05 2011-02-11 4 A 0 30380 0 A 2018-02-10 Common Stock 30380 30380 D These shares were issued pursuant to a restricted stock grant under the American Medical Systems Holdings, Inc. 2005 Stock Incentive Plan (as Amended and Restated), such shares will vest with respect to 25% of the shares on each of February 28, 2012, 2013, 2014 and 2015 and are subject to forfeiture until vested. Includes 4,120 shares issued pursuant to a restricted stock grant under the American Medical Systems Holdings, Inc. 2005 Stock Incentive Plan (as Amended and Restated), such shares are subject to forfeitures until vested and includes 5,723.761 shares that were purchased under the Employee Stock Purchase Plan. The option vests with respect to 25% of the shares on March 31, 2012 and with respect to the remaining shares, quarterly over the next three years. /s/ Thomas K. Rasmussen 2011-02-14