SEC Form 4 · accession 0001179110-15-004726
MERIT MEDICAL SYSTEMS INC · MMSI
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Rashelle Perry
Officer — Chief Legal Officer
Period of report
Mar 9, 2015
Accepted (ET)
Mar 11, 2015 · 4:09 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000856982
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock, No Par Value | Mar 9, 2015 | M | 25,000 | $11.53 | A | 34,435 | D | |
| Common Stock, No Par ValueF3 | Mar 9, 2015 | S | 25,000 | $19.1079 | D | 9,435 | D | |
| Common Stock, No Par ValueF1 | holding | — | — | — | 6,624 | I | By 401(k)plan | |
| Common Stock, No Par ValueF2 | holding | — | — | — | 643 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Non-qualified stock options (right to buy)F4 | $11.53 | Mar 9, 2015 | M | 25,000 | D | May 21, 2009 | May 21, 2015 | Common Stock | 25,000 | 0 | D |
| Non-qualified stock options (right to buy) | $9.71 | holding | — | — | — | Dec 28, 2005 | Dec 28, 2015 | Common Stock | 12,500 | 12,500 | D |
| Non-qualified stock options (right to buy)F5 | $13.75 | holding | — | — | — | Aug 11, 2012 | Aug 11, 2018 | Common Stock | 40,000 | 40,000 | D |
| Non-qualified stock options (right to buy)F6 | $13.14 | holding | — | — | — | Jul 31, 2014 | Jul 31, 2020 | Common Stock | 10,000 | 10,000 | D |
| Non-qualified stock options (right to buy)F7 | $12.06 | holding | — | — | — | Oct 4, 2015 | Oct 4, 2021 | Common Stock | 25,000 | 25,000 | D |
| Non-qualified stock options (right to buy)F8 | $17.27 | holding | — | — | — | Feb 13, 2016 | Feb 13, 2022 | Common Stock | 20,000 | 20,000 | D |
Explanation of responses
- F1Represents plan holdings as of 03/06/2015.
- F2Acquired under the Employee Stock Purchase Plan.
- F3The price reported in Column 4 of Table 1 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $19.00 to $19.29, inclusive. The reporting person undertakes to provide to Merit Medical Systems, Inc., any security holder of Merit Medical Systems, Inc., or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth in this Form 4.
- F4Become exercisable in equal annual installments of 20% commencing 05/21/09.
- F5Become exercisable in equal annual installments of 20% commencing 08/11/12.
- F6Become exercisable in equal annual installments of 20% commencing 07/31/14.
- F7Become exercisable in equal annual installments of 20% commencing 10/04/15.
- F8Become exercisable in equal annual installments of 20% commencing 02/13/16.