SEC Form 5 · accession 0001179110-18-001996
MERIT MEDICAL SYSTEMS INC · MMSI
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Kent W Stanger
Director
Period of report
Dec 31, 2017
Accepted (ET)
Feb 13, 2018 · 3:12 pm EST
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 ValueF4 | Dec 27, 2017 | G | 550 | — | D | 410,984 | D | |
| Common Stock, No Par ValueF1 | holding | — | — | — | 42,277 | I | By 401(k) plan | |
| Common Stock, No Par ValueF2 | holding | — | — | — | 4,271 | D | ||
| Common Stock, No Par ValueF3 | holding | — | — | — | 29,524 | I | Family Limited Partnership |
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)F5 | $13.75 | holding | — | — | — | Aug 11, 2012 | Aug 11, 2018 | Common Stock | 42,000 | 42,000 | D |
| Non-qualified stock options (right to buy)F6 | $12.06 | holding | — | — | — | Oct 4, 2015 | Oct 4, 2021 | Common Stock | 2,000 | 2,000 | D |
| Non-qualified stock options (right to buy)F7 | $19.72 | holding | — | — | — | May 2, 2017 | May 2, 2023 | Common Stock | 9,375 | 9,375 | D |
| Non-qualified stock options (right to buy)F8 | $18.80 | holding | — | — | — | May 26, 2017 | May 26, 2023 | Common Stock | 25,000 | 25,000 | D |
| Non-qualified stock options (right to buy)F9 | $34.40 | holding | — | — | — | May 24, 2018 | May 24, 2024 | Common Stock | 25,000 | 25,000 | D |
Explanation of responses
- F1Represents plan holdings as of 12/31/17.
- F2Employee stock purchase plan as of 12/31/17.
- F3This report shall not be deemed an admission that the reporting person is the beneficial owner of the securities held by K.W.S. Properties LC.
- F4This is a gift.
- F5Becomes exercisable in equal annual installments of 20% commencing on 08/11/2012.
- F6Becomes exercisable in equal annual installments of 20% commencing on 10/04/2015.
- F7Becomes exercisable in equal annual installments of 20% commencing on 05/02/2017.
- F8Becomes exercisable in equal annual installments of 20% commencing on 05/26/2017.
- F9Becomes exercisable in equal annual installments of 20% commencing on 05/24/2018.