Statement of Changes in Beneficial Ownership (4)
March 03 2017 - 6:23PM
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
*
Zakrzewski Joseph S
|
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
_____ Officer (give title below)
_____ Other (specify below)
|
(Last)
(First)
(Middle)
C/O INSULET CORPORATION, 600 TECHNOLOGY PARK DRIVE, SUITE 200
|
3. Date of Earliest Transaction
(MM/DD/YYYY)
3/2/2017
|
(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
|
3/2/2017
|
|
M
|
|
9520
|
A
|
$18.75
|
37369
(1)
|
D
|
|
Common Stock
|
3/2/2017
|
|
M
|
|
18480
|
A
|
$7.06
|
55849
(1)
|
D
|
|
Common Stock
|
3/2/2017
|
|
M
|
|
4000
|
A
|
$14.48
|
59849
(1)
|
D
|
|
Common Stock
|
3/2/2017
|
|
M
|
|
4000
|
A
|
$20.90
|
63849
(1)
|
D
|
|
Common Stock
|
3/2/2017
|
|
M
|
|
4000
|
A
|
$17.75
|
67849
(1)
|
D
|
|
Common Stock
|
3/2/2017
|
|
S
|
|
4000
|
D
|
$48.031
|
63849
(1)
|
D
|
|
Common Stock
|
3/2/2017
|
|
S
|
|
13721
|
D
|
$46.3133
(2)
|
50128
(1)
|
D
|
|
Common Stock
|
3/2/2017
|
|
S
|
|
22279
|
D
|
$46.9907
(3)
|
27849
(1)
|
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
|
Stock Option (Right to Buy)
|
$18.75
|
3/2/2017
|
|
M
|
|
|
9520
|
(4)
|
5/8/2018
|
Common Stock
|
9520
|
$0
|
0
|
D
|
|
Stock Option (Right to Buy)
|
$7.06
|
3/2/2017
|
|
M
|
|
|
18480
|
(5)
|
7/30/2019
|
Common Stock
|
18480
|
$0
|
0
|
D
|
|
Stock Option (Right to Buy)
|
$14.48
|
3/2/2017
|
|
M
|
|
|
4000
|
(5)
|
6/1/2020
|
Common Stock
|
4000
|
$0
|
0
|
D
|
|
Stock Option (Right to Buy)
|
$20.90
|
3/2/2017
|
|
M
|
|
|
4000
|
(6)
|
5/12/2021
|
Common Stock
|
4000
|
$0
|
0
|
D
|
|
Stock Option (Right to Buy)
|
$17.75
|
3/2/2017
|
|
M
|
|
|
4000
|
(7)
|
6/1/2022
|
Common Stock
|
4000
|
$0
|
0
|
D
|
|
Explanation of Responses:
|
(
1)
|
Includes 3,810 restricted stock units granted on May 11, 2016, which vest on April 30, 2017; 1,000 restricted stock units granted on June 2, 2014, which vest on April 30, 2017; and 2,020 restricted stock units granted on May 13, 2015, which vest 50% of the total units on April 30, 2017 and 50% of the total units on April 30, 2018, subject to continued service as a director or consultant. Vested shares will be delivered to the reporting person as soon as practiable following a vesting date.
|
(
2)
|
The price reported represents the weighted average sale price of the shares sold. The shares were sold at varying prices in the range of $45.65 to $46.645. The Reporting Person hereby undertakes, upon request of the Staff of the U.S. Securities Exchange Commission, the Issuer or a security holder of the Issuer, to provide full information regarding the number of shares sold at each separate price.
|
(
3)
|
The price reported represents the weighted average sale price of the shares sold. The shares were sold at varying prices in the range of $46.66 to $47.54. The Reporting Person hereby undertakes, upon request of the Staff of the U.S. Securities Exchange Commission, the Issuer or a security holder of the Issuer, to provide full information regarding the number of shares sold at each separate price.
|
(
4)
|
This option is subject to a three-year vesting period with 50% of the total award vesting one year after the grant date, 25% of the total award vesting two years after the grant date and 25% of the total award vesting three years after the grant date, subject to continued service as a director or consultant.
|
(
5)
|
This option is subject to a three-year vesting period with 50% of the total award vesting on the first anniversary of the date of grant and 25% on each of the second and third anniversaries of the date of grant, subject to continued service as a director or consultant.
|
(
6)
|
This option shall vest as to 100% of the total award on April 30, 2017, subject to continued service as a director or consultant.
|
(
7)
|
This option is subject to a three-year vesting period with 50% of the total award vesting on April 30, 2013, 25% of the total award vesting on April 30, 2014 and 25% of the total award vesting on April 30, 2015, subject to continued service as a director or consultant.
|
Reporting Owners
|
Reporting Owner Name / Address
|
Relationships
|
Director
|
10% Owner
|
Officer
|
Other
|
Zakrzewski Joseph S
C/O INSULET CORPORATION
600 TECHNOLOGY PARK DRIVE, SUITE 200
BILLERICA, MA 01821
|
X
|
|
|
|
Signatures
|
/s/ David Colleran, attorney-in-fact
|
|
3/3/2017
|
**
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