SEC Form 4 · accession 0001179110-16-018207
MERIT MEDICAL SYSTEMS INC · MMSI
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Bernard Birkett
Officer — Chief Financial Officer
Period of report
Jan 28, 2016
Accepted (ET)
Feb 1, 2016 · 5:49 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000856982
Table I — non-derivative securities
No Table I lines on this filing.
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 | $16.05 | Jan 28, 2016 | A | 25,000 | A | Jan 28, 2017 | Jan 28, 2023 | Common Stock | 25,000 | 25,000 | D |
| Non-qualified stock options (right to buy)F1 | $13.75 | holding | — | — | — | Aug 11, 2012 | Aug 11, 2018 | Common Stock | 10,000 | 10,000 | D |
| Non-qualified stock options (right to buy)F2 | $12.06 | holding | — | — | — | Oct 4, 2015 | Oct 4, 2021 | Common Stock | 10,000 | 10,000 | D |
| Non-qualified stock options (right to buy)F3 | $17.27 | holding | — | — | — | Feb 13, 2016 | Feb 13, 2022 | Common Stock | 25,000 | 25,000 | D |
Explanation of responses
- F1Becomes exercisable in equal annual installments of 20% commencing 08/11/12.
- F2Becomes exercisable in equal annual installments of 20% commencing 10/04/15.
- F3Becomes exercisable in equal annual installments of 20% commencing 02/13/16.
- F4Becomes exercisable in equal annual installments of 20% commencing 01/28/17.