Sec Form 4 Filing - Moore Daniel Jeffrey @ TriVascular Technologies, Inc. - 2016-02-03

Insider filing report for Changes in Beneficial Ownership
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FORM 4
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
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
Moore Daniel Jeffrey
2. Issuer Name and Ticker or Trading Symbol
TriVascular Technologies, Inc. [ TRIV]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X __ Director _____ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
(Last) (First) (Middle)
C/O TRIVASCULAR TECHNOLOGIES, INC., 3910 BRICKWAY BLVD.
3. Date of Earliest Transaction (MM/DD/YY)
02/03/2016
(Street)
SANTA ROSA, CA95403
4. If Amendment, Date Original Filed (MM/DD/YY)
6. Individual or Joint/Group Filing (Check Applicable Line)
__ X __ Form filed by One Reporting Person
_____ Form filed by More than One Reporting Person
(City) (State) (Zip)
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Transaction Date (MM/DD/YY) 2A. Deemed Execution Date, if any (MM/DD/YY) 3. Transaction Code
(Instr. 8)
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4)
7. Nature of Indirect Beneficial Ownership
(Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 02/03/2016 M 15,661 A $ 2.43 15,661 D
Common Stock 02/03/2016 F 6,772 ( 1 ) D $ 5.62 8,889 D
Common Stock 02/03/2016 D( 2 ) 8,889 D 0 D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
( e.g. , puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (MM/DD/YY) 3A. Deemed Execution Date, if any (MM/DD/YY) 4. Transaction Code
(Instr. 8)
5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4, and 5)
6. Date Exercisable and Expiration Date
(MM/DD/YY)
7. Title and Amount of Underlying Securities
(Instr. 3 and 4)
8. Price of Derivative Security
(Instr. 5)
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 4)
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 4)
11. Nature of Indirect Beneficial Ownership
(Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Stock Options (Right to buy) $ 2.43 02/03/2016 M 15,661 ( 3 ) 08/29/2022 Common Stock 15,661 $ 0 0 D
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Moore Daniel Jeffrey
C/O TRIVASCULAR TECHNOLOGIES, INC.
3910 BRICKWAY BLVD.
SANTA ROSA, CA95403
X
Signatures
/s/ Michael Kramer, Attorney-In-Fact Daniel J.Moore 02/04/2016
Signature of Reporting Person Date
Explanation of Responses:
( 1 )These shares were withheld by the issuer as payment of the exercise price and calculated for the purposes of the deemed exercise of the options, contingent upon closing of the Merger (as defined below), utilizing the closing price of the issuers common stock on January 28, 2016.
( 2 )These shares were disposed of pursuant to the merger agreement between the issuer and Endologix, Inc. (such transaction, the Merger). In connection with the closing of the Merger, the reporting person received 0.6312 share of Endologix common stock and $0.34 in cash for each share of issuer common stock held by such reporting person, for a total consideration of $4.95 per share based upon the closing price of Endologix common stock on February 2, 2016.
( 3 )These stock options became 100% vested in connection with the Merger.

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* If the form is filed by more than one reporting person, see Instruction 4(b)(v).
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