SEC Form 4 · accession 0001189727-17-000002
ICU MEDICAL INC/DE · ICUI
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Alison D Burcar
Officer — Vice President and Gen'l Mgr.
Period of report
Feb 5, 2017
Accepted (ET)
Feb 6, 2017 · 12:12 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000883984
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Feb 5, 2017 | M | 1,214 | $0.00 | A | 2,046 | D | |
| Common Stock | Feb 5, 2017 | F | 496 | $0.00 | D | 1,550 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Common StockF1,F2,F3 | $0.00 | Feb 5, 2017 | M | 1,214 | D | — | Feb 5, 2019 | Common Stock | 1,214 | 2,429 | D |
Explanation of responses
- F1These securities are Restricted Stock Units.
- F2There is neither a purchase price nor an exercise price for the Restricted Stock Units.
- F3One third of the Units subject to the award shall vest on each of the first, second, and third anniversaries of the grant date.