SEC Form 4 · accession 0001179110-17-007645
MERIT MEDICAL SYSTEMS INC · MMSI
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Michael E Stillabower
Director
Period of report
May 19, 2017
Accepted (ET)
May 19, 2017 · 7:01 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 ValueF1 | May 19, 2017 | M | 25,000 | $13.16 | A | 52,778 | D | |
| Common Stock, No Par ValueF1,F2 | May 19, 2017 | S | 17,110 | $33.7112 | D | 35,668 | 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)F3 | $13.16 | May 19, 2017 | M | 25,000 | D | Jun 25, 2011 | Jun 25, 2017 | Common Stock | 25,000 | 0 | D |
| Non-qualified stock options (right to buy)F4 | $13.75 | holding | — | — | — | Aug 11, 2012 | Aug 11, 2018 | Common Stock | 20,000 | 20,000 | D |
| Non-qualified stock options (right to buy)F5 | $12.91 | holding | — | — | — | May 23, 2013 | May 23, 2019 | Common Stock | 20,000 | 20,000 | D |
| Non-qualified stock options (right to buy)F6 | $9.95 | holding | — | — | — | May 22, 2014 | May 22, 2020 | Common Stock | 25,000 | 25,000 | D |
| Non-qualified stock options (right to buy)F7 | $13.99 | holding | — | — | — | Jun 11, 2015 | Jun 11, 2021 | Common Stock | 25,000 | 25,000 | D |
| Non-qualified stock options (right to buy)F8 | $20.27 | holding | — | — | — | May 22, 2016 | May 22, 2022 | Common Stock | 25,000 | 25,000 | D |
| Non-qualified stock options (right to buy)F9 | $18.80 | holding | — | — | — | May 26, 2017 | May 26, 2023 | Common Stock | 25,000 | 25,000 | D |
Explanation of responses
- F1The Reporting Person paid the exercise price on a cashless basis, resulting in the Issuer's withholding of 17,110 of such shares to pay the exercise price and taxes and issuing the remaining 7,890 shares to the Reporting Person.
- F2The price reported in Column 4 of Table 1 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $33.675 to 33.75, inclusive. The Reporting Person undertakes to provide to Issuer, any security holder of Issuer, 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.
- F3Becomes exercisable in equal annual installments of 20% commencing 06/25/2011.
- F4Becomes exercisable in equal annual installments of 20% commencing 08/11/2012.
- F5Becomes exercisable in equal annual installments of 20% commencing 05/23/2013.
- F6Becomes exercisable in equal annual installments of 20% commencing 05/22/2014.
- F7Becomes exercisable in equal annual installments of 20% commencing 06/11/2015.
- F8Becomes exercisable in equal annual installments of 20% commencing 05/22/2016.
- F9Becomes exercisable in equal annual installments of 20% commencing 05/26/2017.