SEC Form 4 · accession 0001179110-17-006053
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
Apr 14, 2017
Accepted (ET)
Apr 18, 2017 · 7:17 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 ValueF1 | holding | — | — | — | 93,457 | 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. | |
| Common Stock, No Par Value | holding | — | — | — | 1,070,869 | 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)F7 | $28.20 | Apr 14, 2017 | A | 200,000 | A | Apr 14, 2018 | Apr 14, 2029 | Common Stock | 200,000 | 200,000 | D |
| Non-qualified stock options (right to buy)F5,F7 | $28.20 | Apr 14, 2017 | A | 10,000 | A | Apr 14, 2018 | Apr 14, 2029 | Common Stock | 10,000 | 10,000 | I |
| Non-qualified stock options (right to buy)F2 | $13.75 | holding | — | — | — | Aug 11, 2012 | Aug 11, 2018 | Common Stock | 120,000 | 120,000 | D |
| Non-qualified stock options (right to buy)F3 | $12.06 | holding | — | — | — | Oct 4, 2015 | Oct 4, 2021 | Common Stock | 50,000 | 50,000 | D |
| Non-qualified stock options (right to buy)F4 | $17.27 | holding | — | — | — | Feb 13, 2016 | Feb 13, 2022 | Common Stock | 50,000 | 50,000 | D |
| Non-qualified stock options (right to buy)F5,F4 | $17.27 | holding | — | — | — | Feb 13, 2016 | Feb 13, 2022 | Common Stock | 5,000 | 5,000 | I |
| Non-qualified stock options (right to buy)F6 | $16.05 | holding | — | — | — | Jan 28, 2017 | Jan 28, 2023 | Common Stock | 50,000 | 50,000 | D |
| Non-qualified stock options (right to buy)F5,F6 | $16.05 | holding | — | — | — | Jan 28, 2017 | Jan 28, 2023 | Common Stock | 7,500 | 7,500 | I |
Explanation of responses
- F1Represents plan holdings as of 4/14/2017.
- F2Becomes exercisable in equal annual installments of 20% commencing 8/11/2012.
- F3Becomes exercisable in equal annual installments of 20% commencing 10/4/2015.
- F4Becomes exercisable in equal annual installments of 20% commencing 2/13/2016.
- F5Represents derivative securities held by the spouse of the reporting person. The reporting person expressly disclaims beneficial ownership of the securities owned by his spouse.
- F6Becomes exercisable in equal annual installments of 20% commencing 1/28/2017.
- F7Becomes exercisable in equal annual installments of 20% commencing 4/14/2018.