SEC Form 4 · accession 0001179110-16-033105
ST JUDE MEDICAL, LLC · STJ
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Eric S Fain
Officer — Group President
Period of report
Dec 14, 2016
Accepted (ET)
Dec 16, 2016 · 4:23 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000203077
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Dec 12, 2016 | G | 200 | $80.20 | D | 80,092 | D | |
| Common Stock | Dec 14, 2016 | M | 150,000 | $30.58 | A | 230,092 | D | |
| Common StockF2 | Dec 14, 2016 | F | 104,917 | $79.76 | D | 125,175 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock Options (Right to Buy)F3 | $30.58 | Dec 14, 2016 | M | 150,000 | D | Dec 15, 2009 | Dec 15, 2016 | Common Stock | 150,000 | 0 | D |
Explanation of responses
- F1Includes 338 additional shares acquired through the Company Employee Stock Purchase Plan on July 29, 2016.
- F2Shares of common stock withheld to pay the exercise price of the stock options and to pay tax withholdings. The 150,000 shares acquired upon the option exercise, net of 104,917 shares used to pay exercise price and taxes, resulted in 45,083 shares that were retained.
- F3Fully vested at the time of filing.