SEC Form 4/A · accession 0001179110-16-029215
MERIT MEDICAL SYSTEMS INC · MMSI
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
This is an amendment (Form 4/A). It replaces an earlier filing for the same period.
Reporting owner
A Scott Anderson
Director
Period of report
Dec 9, 2015
Accepted (ET)
Sep 1, 2016 · 5:42 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 | Dec 9, 2015 | M | 4,000 | $12.91 | A | 5,000 | D | |
| Common Stock, No Par Value | Dec 9, 2015 | M | 5,000 | $9.95 | A | 10,000 | D | |
| Common Stock, No Par Value | Dec 9, 2015 | M | 5,000 | $13.99 | A | 15,000 | D | |
| Common Stock, No Par ValueF5,F6 | Dec 9, 2015 | S | 10,600 | $18.446 | D | 4,400 | 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 | $12.91 | Dec 9, 2015 | M | 4,000 | D | May 23, 2013 | May 23, 2019 | Common Stock | 4,000 | 8,000 | D |
| Non-qualified stock options (right to buy)F2 | $9.95 | Dec 9, 2015 | M | 5,000 | D | May 22, 2014 | May 22, 2020 | Common Stock | 5,000 | 15,000 | D |
| Non-qualified stock options (right to buy)F3 | $13.99 | Dec 9, 2015 | M | 5,000 | D | Jun 11, 2015 | Jun 11, 2021 | Common Stock | 5,000 | 20,000 | D |
| Non-qualified stock options (right to buy)F4 | $20.27 | holding | — | — | — | May 22, 2016 | May 22, 2022 | Common Stock | 25,000 | 25,000 | D |
Explanation of responses
- F1Becomes exercisable in equal annual installments of 20% commencing 05/23/2013.
- F2Becomes exercisable in equal annual installments of 20% commencing 05/22/2014.
- F3Becomes exercisable in equal annual installments of 20% commencing 06/11/2015.
- F4Becomes exercisable in equal annual installments of 20% commencing 05/22/2016.
- F5The price reported in Column 4 of Table 1 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $18.382 to $18.510, 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.
- F6The initial Form 4 filed on December 11, 2015 by the Reporting Person inadvertently listed the incorrect number of shares beneficially owned in the first line of column 5 of Table I.