SEC Form 4 · accession 0001179110-16-029673
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
Sep 12, 2016
Accepted (ET)
Sep 14, 2016 · 5:01 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 | Sep 12, 2016 | M | 25,000 | $13.82 | A | 1,088,497 | D | |
| Common Stock, No Par Value | Sep 12, 2016 | F | 17,628 | $24.50 | D | 1,070,869 | D | |
| Common Stock, No Par ValueF1 | holding | — | — | — | 92,460 | 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 | — | — | — | 11,817 | I | By spouse. |
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 | $13.82 | Sep 12, 2016 | M | 25,000 | D | Sep 26, 2010 | Sep 26, 2016 | Common Stock | 25,000 | 0 | D |
| Non-qualified stock options (right to buy)F3 | $13.75 | holding | — | — | — | Aug 11, 2012 | Aug 11, 2018 | Common Stock | 120,000 | 120,000 | D |
| Non-qualified stock options (right to buy)F4 | $12.06 | holding | — | — | — | Oct 4, 2015 | Oct 4, 2021 | Common Stock | 50,000 | 50,000 | D |
| Non-qualified stock options (right to buy)F5 | $17.27 | holding | — | — | — | Feb 13, 2016 | Feb 13, 2022 | Common Stock | 50,000 | 50,000 | D |
| Non-qualified stock options (right to buy)F6,F5 | $17.27 | holding | — | — | — | Feb 13, 2016 | Feb 13, 2022 | Common Stock | 5,000 | 5,000 | I |
| Non-qualified stock options (right to buy)F6,F7 | $16.05 | holding | — | — | — | Jan 28, 2017 | Jan 28, 2023 | Common Stock | 7,500 | 7,500 | I |
| Non-qualified stock options (right to buy)F7 | $16.05 | holding | — | — | — | Jan 28, 2017 | Jan 28, 2023 | Common Stock | 50,000 | 50,000 | D |
Explanation of responses
- F1Represents plan holdings as of 9/13/2016.
- F2Becomes exercisable in equal annual installments of 20% commencing 9/26/2010.
- F3Becomes exercisable in equal annual installments of 20% commencing 8/11/2012.
- F4Becomes exercisable in equal annual installments of 20% commencing 10/4/2015.
- F5Becomes exercisable in equal annual installments of 20% commencing 2/13/2016.
- F6Represents derivative securities held by the spouse of the reporting person. The reporting person expressly disclaims beneficial ownership of the securities owned by his spouse.
- F7Becomes exercisable in equal annual installments of 20% commencing 1/28/2017.
- F8Stock options were exercised in a swap transaction with the Company. 17,628 shares of common stock were surrendered in payment of the option exercise price and assorted payroll tax liability. No shares were sold in the open market.