SEC Form 4 · accession 0001144204-17-010268
MEDIFAST INC · MED
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Mehrnaz Mona Ameli
Officer — President, Take Shape For Life
Period of report
Feb 16, 2017
Accepted (ET)
Feb 21, 2017 · 7:58 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000910329
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Feb 16, 2017 | A | 2,375 | $0.00 | A | 7,369 | D | |
| Common StockF2 | Feb 16, 2017 | A | 2,120 | $0.00 | A | 9,489 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Performance Restricted Stock UnitsF3 | — | Feb 16, 2017 | A | 37,950 | A | — | — | Common Stock | 37,950 | 37,950 | D |
| Stock OptionsF4 | $44.73 | Feb 16, 2017 | A | 7,500 | A | — | Feb 16, 2027 | Common Stock | 7,500 | 7,500 | D |
Explanation of responses
- F1Represents shares issued to the reporting person under the 2012 Share Incentive Plan after pre-established performance -based conditions were satisfied for the 2016 performance period.
- F2This annual restricted stock grant, which was issued to the reporting person under the 2012 Share Incentive Plan, will vest annually in equal installments over a period of three years, beginning on the first anniversary of the grant date.
- F3Represents the maximum number of shares that may be earned under this performance-based deferred share award. The actual number of deferred shares that will vest will be determined based on the achievement of certain pre-established performance goals, including the Company's total shareholder return and the price of the Common Stock, following the 2017 performance period.
- F4These non qualified stock options, which were issued to the reporting person under the 2012 Share Incentive Plan, will vest in three equal annual installments beginning on the first anniversary of the grant date.