- Initial Statement of Beneficial Ownership (3)
February 25 2009 - 7:31PM
Edgar (US Regulatory)
FORM 3
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0104
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February 28, 2011
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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
*
Doughty Brian
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2. Date of Event Requiring Statement (MM/DD/YYYY)
2/25/2009
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3. Issuer Name
and
Ticker or Trading Symbol
REPLIDYNE INC [CSII]
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(Last)
(First)
(Middle)
651 CAMPUS DRIVE
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4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
_____ Director
_____ 10% Owner
___
X
___ Officer (give title below)
_____ Other (specify below)
VP of Marketing /
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(Street)
ST. PAUL, MN 55112
(City)
(State)
(Zip)
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5. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_
X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Beneficially Owned
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1.Title of Security
(Instr. 4)
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2. Amount of Securities Beneficially Owned
(Instr. 4)
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3. Ownership Form: Direct (D) or Indirect (I)
(Instr. 5)
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4. Nature of Indirect Beneficial Ownership
(Instr. 5)
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Common Stock
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3170
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D
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Table II - Derivative Securities Beneficially Owned (
e.g.
, puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
(Instr. 4)
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2. Date Exercisable and Expiration Date
(MM/DD/YYYY)
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3. Title and Amount of Securities Underlying Derivative Security
(Instr. 4)
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4. Conversion or Exercise Price of Derivative Security
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5. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 5)
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6. Nature of Indirect Beneficial Ownership
(Instr. 5)
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Date Exercisable
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Expiration Date
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Title
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Amount or Number of Shares
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Stock Option (right to buy)
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(1)
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12/18/2016
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Common Stock
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45290
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$8.83
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D
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Stock Option (right to buy)
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(2)
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4/17/2017
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Common Stock
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3235
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$8.83
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D
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Stock Option (right to buy)
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(3)
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6/11/2017
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Common Stock
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16175
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$7.90
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D
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Stock Option (right to buy)
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(4)
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8/6/2017
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Common Stock
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6470
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$7.90
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D
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Stock Option (right to buy)
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(5)
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12/11/2017
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Common Stock
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32350
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$12.15
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D
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Explanation of Responses:
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(
1)
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Exercisable: 15,096 on 12/19/07 and 15,097 on 12/19/08 and 12/19/09.
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(
2)
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Exercisable: 1,079 on 4/18/08 and 1,078 on 4/18/09 and 4/18/10.
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(
3)
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Exercisable: 5,391 on 6/12/08 and 5,392 on 6/12/09 and 6/12/10.
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(
4)
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Exercisable: 2,156 on 8/7/08 and 2,157 on 8/7/09 and 8/7/10.
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(
5)
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Exercisable: 16,175 on 2/25/10 and 2/25/11.
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Reporting Owners
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Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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Doughty Brian
651 CAMPUS DRIVE
ST. PAUL, MN 55112
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VP of Marketing
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Signatures
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/s/ John R. Remakel as Attorney-in-Fact for Brian Doughty pursuant to Power of Attorney filed herewith.
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2/25/2009
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**
Signature of Reporting Person
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Date
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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*
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If the form is filed by more than one reporting person,
see
Instruction 5(b)(v).
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**
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Intentional misstatements or omissions of facts constitute Federal Criminal Violations.
See
18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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Note:
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File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure.
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Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number.
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