SEC Form 4 · accession 0001209191-15-007239
MEDTRONIC INC · MDT
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Shirley A Jackson
Director
Period of report
Jan 26, 2015
Accepted (ET)
Jan 28, 2015 · 8:47 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000064670
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common stockF1,F2 | Jan 26, 2015 | D | 28,540 | — | D | 0 | 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 | $46.91 | Jan 26, 2015 | D | 1,493 | D | — | Sep 1, 2016 | Common stock | 1,493 | 0 | D |
| Stock options (right to buy)F4 | $52.84 | Jan 26, 2015 | D | 1,010 | D | — | Sep 1, 2017 | Common stock | 1,010 | 0 | D |
| Stock options (right to buy)F5 | $50.34 | Jan 26, 2015 | D | 1,590 | D | — | Apr 28, 2018 | Common stock | 1,590 | 0 | D |
Explanation of responses
- F1Represents shares of Medtronic, Inc. ("Medtronic"), including deferred units credited under a Medtronic, Inc. equity-based plan to be paid in Medtronic, Inc. common stock upon the director's resignation or retirement as well as a balance increase of 111.875 shares since the director's last Form 4 filing due to exempt transactions such as dividend reinvestment, disposed of pursuant to the merger (the "Merger)of a wholly-owned subsidiary of Medtronic plc ("New Medtronic") with and into Medtronic, with Medtronic surviving as a wholly-owned subsidiary of New Medtronic, in exchange for ordinary shares of New Medtronic, which was consummated after and conditioned on New Medtronic's acquisition of Covidien plc, by means of a "scheme of arrangement", an Irish statutory procedure under the Companies Act of 1963. (Continued in Footnote 2)
- F2At the effective time of the Merger, each Medtronic common share (including each deferred unit) was cancelled and converted into the right to receive one New Medtronic ordinary share. Under the terms of the Merger, the director received cash in lieu of fractional shares of New Medtronic and deferred units were rounded up to the nearest whole share.
- F3This option, which was fully vested at the effective time of the Merger, was assumed by New Medtronic in the Merger and converted into an option to purchase 1,493 ordinary shares of New Medtronic for $46.91 per share with the same terms and conditions as the original Medtronic stock option.
- F4This option, which was fully vested at the effective time of the Merger, was assumed by New Medtronic in the Merger and converted into an option to purchase 1,010 ordinary shares of New Medtronic for $52.84 per share with the same terms and conditions as the original Medtronic stock option.
- F5This option, which was fully vested at the effective time of the Merger, was assumed by New Medtronic in the Merger and converted into an option to purchase 1,590 ordinary shares of New Medtronic for $50.34 per share with the same terms and conditions as the original Medtronic stock option.