SEC Form 4 · accession 0001179110-15-016446
MERIT MEDICAL SYSTEMS INC · MMSI
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Fred P Lampropoulos
Officer — President & CEO · Director
Period of report
Dec 15, 2015
Accepted (ET)
Dec 17, 2015 · 7:12 pm EST
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 ValueF2 | Dec 15, 2015 | M | 3,125 | $9.71 | A | 14,942 | I | Please refer to footnote number two (2) |
| Common Stock, No Par ValueF3 | Dec 15, 2015 | S | 3,125 | $18.4684 | D | 11,817 | I | Please refer to footnote number three (3) |
| Common Stock, No Par ValueF1 | holding | — | — | — | 90,859 | I | By 401(k) Plan | |
| Common Stock, No Par Value | holding | — | — | — | 90 | I | By spouse as custodian for child. | |
| Common Stock, No Par Value | holding | — | — | — | 1,063,497 | 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)F2 | $9.71 | Dec 15, 2015 | M | 3,125 | D | Dec 28, 2005 | Dec 28, 2015 | Common Stock | 3,125 | 0 | I |
Explanation of responses
- F1Represents plan holdings as of 12/15/2015.
- F2Represents the exercise of stock options held by the spouse of the reporting person. The reporting person expressly disclaims beneficial ownership of the securities owned by his spouse.
- F3Represents the sale of shares held by the spouse of the reporting person. The reporting person expressly disclaims beneficial ownership of the securities owned by his spouse.