Statement of Changes in Beneficial Ownership (4)
March 02 2021 - 6:33PM
Edgar (US Regulatory)
FORM 4
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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
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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
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LAMPROPOULOS FRED P |
2. Issuer Name and Ticker or Trading Symbol
MERIT MEDICAL SYSTEMS INC
[
MMSI
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director _____ 10% Owner __X__ Officer (give title below) _____ Other (specify below) PRESIDENT AND CEO |
(Last)
(First)
(Middle)
1600 WEST MERIT PARKWAY |
3. Date of Earliest Transaction
(MM/DD/YYYY)
2/26/2021 |
(Street)
SOUTH JORDAN, UT 84095
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security (Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code (Instr. 8)
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4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Common Stock, No Par Value | 2/26/2021 | | A | | 8840 (1) | A | $0 | 976756 | D | |
Common Stock, No Par Value | 2/26/2021 | | F | | 3893 | D | $55.72 | 972863 | D | |
Common Stock, No Par Value | | | | | | | | 95862.542 | I | By 401(k) Plan (2) |
Common Stock, No Par Value | | | | | | | | 90 | I | By spouse as custodian for child |
Common Stock, No Par Value | | | | | | | | 1269 | I | By spouse |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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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 |
Non-qualified stock options (right to buy) | $17.27 | | | | | | | 2/13/2016 (3) | 2/13/2022 | Common Stock | 5000 | | 5000 | I | See footnote (4) |
Non-qualified stock options (right to buy) | $16.05 | | | | | | | 1/28/2017 (5) | 1/28/2023 | Common Stock | 50000 | | 50000 | D | |
Non-qualified stock options (right to buy) | $16.05 | | | | | | | 1/28/2017 (6) | 1/28/2023 | Common Stock | 6000 | | 6000 | I | See footnote (4) |
Non-qualified stock options (right to buy) | $28.20 | | | | | | | 4/14/2018 (7) | 4/14/2024 | Common Stock | 200000 | | 200000 | D | |
Non-qualified stock options (right to buy) | $28.20 | | | | | | | 4/14/2018 (8) | 4/14/2024 | Common Stock | 6000 | | 6000 | I | See footnote (4) |
Non-qualified stock options (right to buy) | $44.80 | | | | | | | 3/2/2019 (9) | 3/2/2025 | Common Stock | 38002 | | 38002 | D | |
Non-qualified stock options (right to buy) | $44.80 | | | | | | | 3/2/2019 (10) | 3/2/2025 | Common Stock | 4000 | | 4000 | I | See footnote (4) |
Non-qualified stock options (right to buy) | $55.73 | | | | | | | 3/1/2020 (11) | 3/1/2026 | Common Stock | 159151 | | 159151 | D | |
Non-qualified stock options (right to buy) | $55.73 | | | | | | | 3/1/2020 (12) | 3/1/2026 | Common Stock | 2000 | | 2000 | I | See footnote (4) |
Non-qualified stock options (right to buy) | $37.71 | | | | | | | 2/26/2021 (13) | 2/26/2027 | Common Stock | 100334 | | 100334 | D | |
Explanation of Responses: |
(1) | These shares were acquired upon a determination of the Company's Compensation and Talent Development Committee that certain conditions had been met for the issuance of such shares pursuant to performance stock units that were granted on February 26, 2020. |
(2) | Represents plan holdings as of 2/26/2021. |
(3) | Became exercisable in equal annual installments of 20% commencing 2/13/2016. |
(4) | Represents derivative securities held by the spouse of the reporting person. The reporting person expressly disclaims beneficial ownership of the securities owned by his spouse. |
(5) | Becomes exercisable in equal annual installments of 20% commencing 1/28/2017. |
(6) | Original grant of 7,500 options was to become vested and exercisable in equal annual installments of 20% commencing 1/28/2017. Options not vested as of 6/22/2020 have been forfeited. |
(7) | Becomes exercisable in equal annual installments of 20% commencing 4/14/2018. |
(8) | Original grant of 10,000 options was to become vested and exercisable in equal annual installments of 20% commencing 4/14/2018. Options not vested as of 6/22/2020 have been forfeited. |
(9) | Becomes exercisable in equal annual installments of 20% commencing 3/2/2019. |
(10) | Original grant of 10,000 options was to become vested and exercisable in equal annual installments of 20% commencing 3/2/2019. Options not vested as of 6/22/2020 have been forfeited. |
(11) | Becomes exercisable in equal annual installments of 20% commencing 3/1/2020. |
(12) | Original grant of 10,000 options was to become vested and exercisable in equal annual installments of 20% commencing 3/1/2020. Options not vested as of 6/22/2020 have been forfeited. |
(13) | Becomes exercisable in equal annual installments of 25% commencing 2/26/2021. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
LAMPROPOULOS FRED P 1600 WEST MERIT PARKWAY SOUTH JORDAN, UT 84095 | X |
| PRESIDENT AND CEO |
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Signatures
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/s/ Brian G. Lloyd, Attorney-in-Fact | | 3/2/2021 |
**Signature of Reporting Person | Date |
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