Statement of Changes in Beneficial Ownership (4)
October 14 2016 - 8:50AM
Edgar (US Regulatory)
FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue.
See
Instruction 1(b).
|
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
|
OMB APPROVAL
OMB Number:
3235-0287
Estimated average burden
hours per response...
0.5
|
|
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
|
|
1. Name and Address of Reporting Person
*
SULLIVAN PATRICK J
|
2. Issuer Name
and
Ticker or Trading Symbol
INSULET CORP
[
PODD
]
|
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__
X
__ Director
_____ 10% Owner
__
X
__ Officer (give title below)
_____ Other (specify below)
President & CEO
|
(Last)
(First)
(Middle)
C/O INSULET CORPORATION, 600 TECHNOLOGY PARK DRIVE, SUITE 200
|
3. Date of Earliest Transaction
(MM/DD/YYYY)
10/12/2016
|
(Street)
BILLERICA, MA 01821
(City)
(State)
(Zip)
|
4. If Amendment, Date Original Filed
(MM/DD/YYYY)
|
6. Individual or Joint/Group Filing
(Check Applicable Line)
_
X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
|
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
|
1.Title of Security
(Instr. 3)
|
2. Trans. Date
|
2A. Deemed Execution Date, if any
|
3. Trans. Code
(Instr. 8)
|
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
|
5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
|
6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
|
7. Nature of Indirect Beneficial Ownership (Instr. 4)
|
Code
|
V
|
Amount
|
(A) or (D)
|
Price
|
Common Stock
|
10/12/2016
|
|
M
|
|
3075
|
A
|
$32.51
|
221544
(1)
(2)
(3)
|
D
|
|
Table II - Derivative Securities Beneficially Owned (
e.g.
, puts, calls, warrants, options, convertible securities)
|
1. Title of Derivate Security
(Instr. 3)
|
2. Conversion or Exercise Price of Derivative Security
|
3. Trans. Date
|
3A. Deemed Execution Date, if any
|
4. Trans. Code
(Instr. 8)
|
5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
|
6. Date Exercisable and Expiration Date
|
7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4)
|
8. Price of Derivative Security
(Instr. 5)
|
9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)
|
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4)
|
11. Nature of Indirect Beneficial Ownership (Instr. 4)
|
Code
|
V
|
(A)
|
(D)
|
Date Exercisable
|
Expiration Date
|
Title
|
Amount or Number of Shares
|
Employee Stock Option (Right to Buy)
|
$32.51
|
10/12/2016
|
|
M
|
|
|
3075
|
(4)
|
3/2/2025
|
Common Stock
|
3075
(3)
|
$0
|
59110
|
D
|
|
Explanation of Responses:
|
(
1)
|
Includes 777 shares acquired on December 31, 2015 and 674 shares acquired on June 30, 2016 under the Insulet Corporation 2007 Employee Stock Purchase Plan.
|
(
2)
|
Includes 29,100 restricted stock units granted on March 2, 2015, which vest one-half of the total units on March 2, 2017 and one-half of the total units on March 2, 2018; 30,432 performance share units granted on April 1, 2015, which vest one-half of the total performance share units on April 1, 2017 and one-half of the total performance share units on April 1, 2018; and 42,720 restricted stock units granted on February 24, 2016, which vest one-third of the total units on February 24, 2017, one-third of the total units on February 24, 2018 and one-third of the total units on February 24, 2019. Vested shares will be delivered to the reporting person as soon as practicable following a vesting date.
|
(
3)
|
The transaction referenced in Tables I and II represents the exercise for cash by the reporting person of options to acquire 3,075 shares of the Company's common stock. All of the underlying shares of common stock issued upon exercise of the options have been retained by the reporting person and no sale of common stock occurred in connection with this transaction.
|
(
4)
|
This option is subject to a four-year vesting period, with 25% of the total award vesting one year after the grant date and the remainder vesting in equal quarterly installments each quarter thereafter for 12 quarters, subject to continued employment.
|
Reporting Owners
|
Reporting Owner Name / Address
|
Relationships
|
Director
|
10% Owner
|
Officer
|
Other
|
SULLIVAN PATRICK J
C/O INSULET CORPORATION
600 TECHNOLOGY PARK DRIVE, SUITE 200
BILLERICA, MA 01821
|
X
|
|
President & CEO
|
|
Signatures
|
/s/ David Colleran, attorney-in-fact
|
|
10/14/2016
|
**
Signature of Reporting Person
|
Date
|
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
|
*
|
If the form is filed by more than one reporting person,
see
Instruction 4(b)(v).
|
**
|
Intentional misstatements or omissions of facts constitute Federal Criminal Violations.
See
18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
|
Note:
|
File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure.
|
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number.
|
Insulet (NASDAQ:PODD)
Historical Stock Chart
From Mar 2024 to Apr 2024
Insulet (NASDAQ:PODD)
Historical Stock Chart
From Apr 2023 to Apr 2024