SEC Form 4 · accession 0001179110-16-028665
MERIT MEDICAL SYSTEMS INC · MMSI
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Richard W Edelman
Director
Period of report
Aug 11, 2016
Accepted (ET)
Aug 12, 2016 · 7:11 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 | Aug 11, 2016 | M | 17,682 | $13.82 | A | 20,682 | D | |
| Common Stock, No Par ValueF9 | Aug 11, 2016 | S | 17,682 | $23.51 | D | 3,000 | D | |
| Common Stock, No Par Value | Aug 12, 2016 | M | 6,818 | $13.82 | A | 9,818 | D | |
| Common Stock, No Par ValueF9 | Aug 12, 2016 | S | 3,818 | $23.51 | D | 6,000 | 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)F1 | $13.82 | Aug 11, 2016 | M | 17,682 | D | Sep 26, 2010 | Sep 26, 2016 | Common Stock | 17,682 | 6,818 | D |
| Non-qualified stock options (right to buy)F1 | $13.82 | Aug 12, 2016 | M | 6,818 | D | Sep 26, 2010 | Sep 26, 2016 | Common Stock | 6,818 | 0 | D |
| Non-qualified stock options (right to buy)F2 | $13.16 | holding | — | — | — | Jun 25, 2011 | Jun 25, 2017 | Common Stock | 25,000 | 25,000 | D |
| Non-qualified stock options (right to buy)F3 | $13.75 | holding | — | — | — | Aug 11, 2012 | Aug 11, 2018 | Common Stock | 20,000 | 20,000 | D |
| Non-qualified stock options (right to buy)F4 | $12.91 | holding | — | — | — | May 23, 2013 | May 23, 2019 | Common Stock | 20,000 | 20,000 | D |
| Non-qualified stock options (right to buy)F5 | $9.95 | holding | — | — | — | May 22, 2014 | May 22, 2020 | Common Stock | 25,000 | 25,000 | D |
| Non-qualified stock options (right to buy)F6 | $13.99 | holding | — | — | — | Jun 11, 2015 | Jun 11, 2021 | Common Stock | 25,000 | 25,000 | D |
| Non-qualified stock options (right to buy)F7 | $20.27 | holding | — | — | — | May 22, 2016 | May 22, 2022 | Common Stock | 25,000 | 25,000 | D |
| Non-qualified stock options (right to buy)F8 | $18.80 | holding | — | — | — | May 26, 2017 | May 26, 2023 | Common Stock | 25,000 | 25,000 | D |
Explanation of responses
- F1Becomes exercisable in equal annual installments of 20% commencing 09/26/2010.
- F2Becomes exercisable in equal annual installments of 20% commencing 06/25/2011.
- F3Becomes exercisable in equal annual installments of 20% commencing 08/11/2012.
- F4Becomes exercisable in equal annual installments of 20% commencing 05/23/2013.
- F5Becomes exercisable in equal annual installments of 20% commencing 05/22/2014.
- F6Becomes exercisable in equal annual installments of 20% commencing 06/11/2015.
- F7Becomes exercisable in equal annual installments of 20% commencing 05/22/2016.
- F8Becomes exercisable in equal annual installments of 20% commencing 05/26/2017.
- F9The price reported in Column 4 of Table 1 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $23.51 to 23.52, 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.