SEC Form 4 · accession 0001179110-16-033192
ST JUDE MEDICAL, LLC · STJ
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Michael T Rousseau
Officer — Director, President and CEO · Director
Period of report
Dec 15, 2012
Accepted (ET)
Dec 19, 2016 · 4:10 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 15, 2012 | M | 50,000 | $30.58 | A | 50,000 | I | Family Trust |
| Common StockF2,F1 | Dec 15, 2012 | F | 30,382 | $79.88 | D | 19,618 | I | Family Trust |
| Common StockF3 | holding | — | — | — | 31,822 | 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)F4 | $30.58 | Oct 18, 2016 | G | 50,000 | D | Dec 15, 2009 | Dec 15, 2016 | Common Stock | 50,000 | 0 | D |
| Stock Options (Right to Buy)F1,F4 | $30.58 | Oct 18, 2016 | G | 50,000 | A | Dec 15, 2009 | Dec 15, 2016 | Common Stock | 50,000 | 50,000 | I |
| Stock Options (Right to Buy)F1,F4 | $30.58 | Dec 15, 2016 | M | 50,000 | D | Dec 15, 2009 | Dec 15, 2016 | Common Stock | 50,000 | 0 | I |
| Stock Options (Right to Buy)F4 | $30.59 | Oct 18, 2016 | G | 182,000 | D | Dec 14, 2010 | Dec 14, 2017 | Common Stock | 182,000 | 0 | D |
| Stock Options (Right to Buy)F1,F4 | $30.59 | Oct 18, 2016 | G | 182,000 | A | Dec 14, 2010 | Dec 14, 2017 | Common Stock | 182,000 | 182,000 | I |
| Stock Options (Right to Buy)F4 | $41.65 | Oct 18, 2016 | G | 204,000 | D | Dec 14, 2011 | Dec 14, 2018 | Common Stock | 204,000 | 0 | D |
| Stock Options (Right to Buy)F1,F4 | $41.65 | Oct 18, 2016 | G | 204,000 | A | Dec 14, 2011 | Dec 14, 2017 | Common Stock | 204,000 | 204,000 | I |
| Stock Options (Right to Buy)F4 | $34.96 | Oct 18, 2016 | G | 300,000 | D | Dec 17, 2012 | Dec 12, 2019 | Common Stock | 300,000 | 0 | D |
| Stock Options (Right to Buy)F1,F4 | $34.96 | Oct 18, 2016 | G | 300,000 | A | Dec 17, 2012 | Dec 12, 2019 | Common Stock | 300,000 | 300,000 | I |
| Stock Options (Right to Buy)F5 | $35.27 | Oct 18, 2016 | G | 183,750 | D | Dec 17, 2013 | Dec 10, 2020 | Common Stock | 245,000 | 61,250 | D |
| Stock Options (Right to Buy)F1,F5 | $35.27 | Oct 18, 2016 | G | 183,750 | A | Dec 17, 2013 | Dec 10, 2020 | Common Stock | 183,750 | 183,750 | I |
| Stock Options (Right to Buy)F5 | $59.41 | Oct 18, 2016 | G | 74,570 | D | Dec 17, 2014 | Dec 10, 2021 | Common Stock | 149,140 | 74,570 | D |
| Stock Options (Right to Buy)F1,F5 | $59.41 | Oct 18, 2016 | G | 74,570 | A | Dec 17, 2014 | Dec 10, 2021 | Common Stock | 74,570 | 74,570 | I |
| Stock Options (Right to Buy)F5 | $69.08 | Oct 18, 2016 | G | 36,148 | D | Dec 17, 2015 | Dec 8, 2022 | Common Stock | 144,592 | 108,444 | D |
| Stock Options (Right to Buy)F1,F5 | $69.08 | Oct 18, 2016 | G | 36,148 | A | Dec 17, 2015 | Dec 8, 2022 | Common Stock | 36,148 | 36,148 | I |
Explanation of responses
- F1The reporting person disclaims beneficial ownership of these securities, and this report shall not be deemed an admission that the reporting person is the beneficial owner of the securities for purposes of Section 16 or for any other purpose.
- F2Shares of common stock withheld to pay the exercise price of the stock options and to pay tax withholdings. The 50,000 shares acquired upon the option exercise, net of 30,382 shares used to pay exercise price and taxes, resulted in 19,618 shares that were retained.
- F3Includes 338 additional shares acquired through the Company Employee Stock Purchase Plan on 7/29/16.
- F4Fully vested at the time of filing.
- F5The option shares vest 25% on each of the first four anniversary dates of the date of the grant beginning on the date shown.