SEC Form 4 · accession 0001127602-17-008311
INSULET CORP · PODD
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Shacey Petrovic
Officer — President and COO
Period of report
Feb 22, 2017
Accepted (ET)
Feb 24, 2017 · 6:38 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001145197
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1,F2,F3 | Feb 22, 2017 | A | 13,522 | $0.00 | A | 86,725 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Employee Stock Option (Right to Buy)F4 | $46.22 | Feb 22, 2017 | A | 35,538 | A | — | Feb 22, 2027 | Common Stock | 35,538 | 35,538 | D |
Explanation of responses
- F1The 13,522 restricted stock units vest one-third of the total units on February 22, 2018, and one-third of the total units on February 22, 2019, and one-third of the total units on February 22, 2020, subject to continued employment. Vested shares will be delivered to the reporting person as soon as practicable following a vesting date.
- F2Includes 18,989 restricted stock units granted on February 9, 2015, which vest on February 9, 2018; 4,542 performance share units granted on April 1, 2015, which vest one-half of the total performance share units on April 1, 2017 and one-half of the total performance share units on April 1, 2018; and 14,240 restricted stock units granted on February 24, 2016, which vest one-half of the total units on February 24, 2018 and one-half of the total units on February 24, 2019, subject to continued employment. Vested shares will be delivered to the reporting person as soon as practicable following a vesting date.
- F3Includes an aggregate of 1,386 shares acquired under the Insulet Corporation 2007 Employee Stock Purchase Plan on the following dates: 712 shares on December 31, 2015 and 674 shares on June 30, 2016.
- F4This option is subject to a four-year vesting period with 25% of the total award vesting one year after the grant date and the remainder vesting in equal quarterly installments each quarter thereafter for 12 quarters, subject to continued employment.