SEC Form 4 · accession 0001179110-17-011237
MERIT MEDICAL SYSTEMS INC · MMSI
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
A Scott Anderson
Director
Period of report
Aug 7, 2017
Accepted (ET)
Aug 8, 2017 · 5:22 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 7, 2017 | M | 4,000 | $12.91 | A | 10,400 | D | |
| Common Stock, No Par Value | Aug 7, 2017 | M | 5,000 | $9.95 | A | 15,400 | D | |
| Common Stock, No Par Value | Aug 7, 2017 | M | 1,000 | $13.99 | A | 16,400 | D | |
| Common Stock, No Par Value | Aug 7, 2017 | M | 10,000 | $20.27 | A | 26,400 | D | |
| Common Stock, No Par Value | Aug 7, 2017 | M | 5,000 | $18.80 | A | 31,400 | D | |
| Common Stock, No Par ValueF1 | Aug 7, 2017 | S | 25,000 | $41.15 | D | 6,400 | 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)F2 | $12.91 | Aug 7, 2017 | M | 4,000 | D | May 23, 2013 | May 23, 2019 | Common Stock | 4,000 | 0 | D |
| Non-qualified stock options (right to buy)F3 | $9.95 | Aug 7, 2017 | M | 5,000 | D | May 22, 2014 | May 22, 2020 | Common Stock | 5,000 | 5,000 | D |
| Non-qualified stock options (right to buy)F4 | $13.99 | Aug 7, 2017 | M | 1,000 | D | Jun 11, 2015 | Jun 11, 2021 | Common Stock | 1,000 | 14,000 | D |
| Non-qualified stock options (right to buy)F5 | $20.27 | Aug 7, 2017 | M | 10,000 | D | May 22, 2016 | May 22, 2022 | Common Stock | 10,000 | 15,000 | D |
| Non-qualified stock options (right to buy)F6 | $18.80 | Aug 7, 2017 | M | 5,000 | D | May 26, 2017 | May 26, 2023 | Common Stock | 5,000 | 20,000 | D |
| Non-qualified stock options (right to buy)F7 | $34.40 | holding | — | — | — | May 24, 2018 | May 24, 2024 | Common Stock | 25,000 | 25,000 | D |
Explanation of responses
- F1The price reported in Column 4 of Table 1 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $41.10 to 41.25, 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.
- F2Becomes exercisable in equal annual installments of 20% commencing 05/23/2013.
- F3Becomes exercisable in equal annual installments of 20% commencing 05/22/2014.
- F4Becomes exercisable in equal annual installments of 20% commencing 06/11/2015.
- F5Becomes exercisable in equal annual installments of 20% commencing 05/22/2016.
- F6Becomes exercisable in equal annual installments of 20% commencing 05/26/2017.
- F7Becomes exercisable in equal annual installments of 20% commencing 05/24/2018.