SEC Form 4 · accession 0001127602-17-010311

INSULET CORP · PODD

Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗

Reporting owner

Joseph S Zakrzewski

Director

Period of report

Mar 2, 2017

Accepted (ET)

Mar 3, 2017 · 6:22 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
Common Stock^F1	Mar 2, 2017	M	9,520	$18.75	A	37,369	D
Common Stock^F1	Mar 2, 2017	M	18,480	$7.06	A	55,849	D
Common Stock^F1	Mar 2, 2017	M	4,000	$14.48	A	59,849	D
Common Stock^F1	Mar 2, 2017	M	4,000	$20.90	A	63,849	D
Common Stock^F1	Mar 2, 2017	M	4,000	$17.75	A	67,849	D
Common Stock^F1	Mar 2, 2017	S	4,000	$48.031	D	63,849	D
Common Stock^F2,F1	Mar 2, 2017	S	13,721	$46.3133	D	50,128	D
Common Stock^F3,F1	Mar 2, 2017	S	22,279	$46.9907	D	27,849	D

Table II — derivative securities

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	D/I
Stock Option (Right to Buy)^F4	$18.75	Mar 2, 2017	M	9,520	D	—	May 8, 2018	Common Stock	9,520	D
Stock Option (Right to Buy)^F5	$7.06	Mar 2, 2017	M	18,480	D	—	Jul 30, 2019	Common Stock	18,480	D
Stock Option (Right to Buy)^F5	$14.48	Mar 2, 2017	M	4,000	D	—	Jun 1, 2020	Common Stock	4,000	D
Stock Option (Right to Buy)^F6	$20.90	Mar 2, 2017	M	4,000	D	—	May 12, 2021	Common Stock	4,000	D
Stock Option (Right to Buy)^F7	$17.75	Mar 2, 2017	M	4,000	D	—	Jun 1, 2022	Common Stock	4,000	D

Explanation of responses

F1Includes 3,810 restricted stock units granted on May 11, 2016, which vest on April 30, 2017; 1,000 restricted stock units granted on June 2, 2014, which vest on April 30, 2017; and 2,020 restricted stock units granted on May 13, 2015, which vest 50% of the total units on April 30, 2017 and 50% of the total units on April 30, 2018, subject to continued service as a director or consultant. Vested shares will be delivered to the reporting person as soon as practiable following a vesting date.
F2The price reported represents the weighted average sale price of the shares sold. The shares were sold at varying prices in the range of $45.65 to $46.645. The Reporting Person hereby undertakes, upon request of the Staff of the U.S. Securities Exchange Commission, the Issuer or a security holder of the Issuer, to provide full information regarding the number of shares sold at each separate price.
F3The price reported represents the weighted average sale price of the shares sold. The shares were sold at varying prices in the range of $46.66 to $47.54. The Reporting Person hereby undertakes, upon request of the Staff of the U.S. Securities Exchange Commission, the Issuer or a security holder of the Issuer, to provide full information regarding the number of shares sold at each separate price.
F4This option is subject to a three-year vesting period with 50% of the total award vesting one year after the grant date, 25% of the total award vesting two years after the grant date and 25% of the total award vesting three years after the grant date, subject to continued service as a director or consultant.
F5This option is subject to a three-year vesting period with 50% of the total award vesting on the first anniversary of the date of grant and 25% on each of the second and third anniversaries of the date of grant, subject to continued service as a director or consultant.
F6This option shall vest as to 100% of the total award on April 30, 2017, subject to continued service as a director or consultant.
F7This option is subject to a three-year vesting period with 50% of the total award vesting on April 30, 2013, 25% of the total award vesting on April 30, 2014 and 25% of the total award vesting on April 30, 2015, subject to continued service as a director or consultant.