SEC Form 4 · accession 0001127602-18-011889
INSULET CORP · PODD
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Patrick J Sullivan
Officer — CEO and Chairman of the Board · Director
Period of report
Mar 14, 2018
Accepted (ET)
Mar 16, 2018 · 6:16 pm EDT
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 StockF2 | Mar 14, 2018 | J | 59,084 | $84.625 | A | 329,516 | D | |
| Common Stock | holding | — | — | — | 28,336 | I | By Grantor Retained Annuity Trust |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1On March 14, 2018, the reporting person withdrew 59,084 shares of Insulet Corporation common stock from a grantor retained annuity trust. In exchange for the shares, the reporting person contributed to the trust $5 million in cash and other assets. The withdrawal of shares from the trust resulted in a decrease in the number of shares the reporting person beneficially owns indirectly through the trust and a corresponding increase in the number of shares the reporting person beneficially owns directly. The reporting person believes that his withdrawal of shares from the trust constitutes a change in form of beneficial ownership of the shares exempted by Rule 16a-13 under the Securities Exchange Act of 1934.
- F2Includes 15,216 performance share units granted on April 1, 2015, which vest on April 1, 2018; 14,240 restricted stock units granted on February 24, 2016, which vest on February 24, 2019; 12,022 restricted stock units granted on February 22, 2017, which vest one-half of the total units on February 22, 2019 and one-half of the total units on February 22, 2020; 51,266 performance share units granted on February 24, 2016, which vest on February 24, 2019; and 12,081 restricted stock units granted on February 14, 2018, which vest as to one-third of the total units on February 14, 2019, one-third of the total units on February 14, 2020 and one-third of the total units on February 14, 2021. Vested shares will be delivered to the reporting person as soon as practicable following a vesting date.