SEC FORM 4 SEC Form 4
FORM 4 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
or Section 30(h) of the Investment Company Act of 1940
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
Richard Patrick

(Last) (First) (Middle)
C/O LDR HOLDING CORPORATION
13785 RESEARCH BLVD STE 200

(Street)
AUSTIN TX 78750

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
LDR HOLDING CORP [ LDRH ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
EVP, LDR Medical
3. Date of Earliest Transaction (Month/Day/Year)
06/29/2016
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 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 06/29/2016 J 0.0598(1) D $37(1) 92,999.9402(1) I By Richard's Investments(1)
Common Stock 06/29/2016 J 0.0299(1) A $37(1) 0.0299(1)(2) I By Richard's Investments(1)
Common Stock 06/29/2016 J 0.0299(1) A $37(1) 0.0299(1)(2) I By Richard's Investments(1)
Common Stock 435,463 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 (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 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 (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (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: 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
Explanation of Responses:
1. The shares are owned by Richard's Investments, a French societe civile. On June 29, 2016, the reporting person contributed 93,000 shares that he held directly to Richard's Investments, a newly formed entity, in exchange for 3,107,025 shares of Richard's Investments (such number equal to the value, in Euros, of the contributed shares based on a $37.00 per share valuation) in an exempt transaction under Rule 16a-13. The reporting person retains full investment and voting power over the shares held by Richard's Investments. Following this contribution, each of the reporting person's two children contributed 1 Euro in cash to Richard's Investments in exchange for 1 share of Richard's Investments. As a result, the reporting person directly holds 3,107,025 of the 3,107,027 outstanding shares of Richard's Investments and each of the reporting person's two children directly hold 1 share of Richard's Investments.
2. The reporting person disclaims beneficial ownership of the shares that are held by his children, and this report should not be deemed an admission that the reporting person is the beneficial owner of his children's shares for purposes of Section 16 or for any other purpose.
Remarks:
By: /s/ Denise Cruz for Patrick Richard 07/06/2016
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: 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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