SEC Form 4 · accession 0001179110-16-033189
ST JUDE MEDICAL, LLC · STJ
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Lisa Andrade
Officer — VP and Chief Marketing Officer
Period of report
Dec 15, 2016
Accepted (ET)
Dec 19, 2016 · 4:07 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 Stock | Dec 15, 2016 | M | 1,500 | $30.58 | A | 9,155 | D | |
| Common StockF1 | Dec 15, 2016 | F | 828 | $79.88 | D | 8,327 | 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)F2 | $30.58 | Dec 15, 2016 | M | 1,500 | D | Dec 15, 2009 | Dec 15, 2016 | Common Stock | 1,500 | 0 | D |
Explanation of responses
- F1Shares of common stock withheld to pay the exercise price of the stock options and to pay tax withholdings. The 1,500 shares acquired upon the option exercise, net of 828 shares used to pay exercise price and taxes, resulted in 672 shares that were retained.
- F2Fully vested at the time of filing.