FORM 3 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES 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*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 05/05/2017 |
3. Issuer Name and Ticker or Trading Symbol
TELEFLEX INC [ TFX ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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5. If Amendment, Date of Original Filed
(Month/Day/Year) |
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6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Beneficially Owned | |||
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1. Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
Common Stock | 3,881(1) | D | |
Common Stock | 4.203(2) | I | By 401(k) Trustee |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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1. Title of Derivative Security (Instr. 4) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) | ||
Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Stock Option / (Right to Buy) | (3) | 07/29/2023 | Common Stock | 1,258 | $79.48 | D | |
Stock Option / (Right to Buy) | (4) | 02/26/2024 | Common Stock | 988 | $101.12 | D | |
Stock Option / (Right to Buy) | (5) | 02/25/2025 | Common Stock | 1,950 | $121 | D | |
Stock Option / (Right to Buy) | (6) | 03/01/2026 | Common Stock | 3,543 | $144.79 | D | |
Stock Option / (Right to Buy) | (7) | 02/28/2027 | Common Stock | 3,645 | $191.18 | D |
Explanation of Responses: |
1. Represents the total of (a) 2,344 shares held directly by the reporting person; (b) 572 shares underlying a restricted stock award that was granted on 2/25/2015; (c) 544 shares underlying a restricted stock award that was granted on 3/1/2016; and (d) 421 shares underlying a restricted stock award that was granted on 2/28/2017. Each restricted stock award vests in its entirety on the third anniversary of the grant date. |
2. Total number of shares is based on a plan statement dated as of May 5, 2017. |
3. This stock option, which was granted on 7/29/2013 and provided the reporting person the right to purchase up to 5,906 shares, became exercisable for one-third of the shares on each of 7/29/2014, 7/29/2015 and 7/29/2016. A portion of this stock option was previously exercised. |
4. This stock option, which was granted on 2/26/2014 and provided the reporting person the right to purchase up to 5,664 shares, became exercisable for one-third of the shares on each of 2/26/2015, 2/26/2016 and 2/26/2017. A portion of this stock option was previously exercised. |
5. This stock option, which was granted on 2/25/2015 and provided the reporting person the right to purchase up to 5,850 shares, became exercisable for one-third of the shares on each of 2/25/2016, 2/25/2017 and 2/25/2018. A portion of this stock option was previously exercised. |
6. This stock option, which was granted on 3/1/2016 and provided the reporting person the right to purchase up to 5,314 shares, became exercisable for one-third of the shares on each of 3/1/2017, 3/1/2018 and 3/1/2019. A portion of this stock option was previously exercised. |
7. Exercisable for one-third of the shares on each of 2/28/2018, 2/28/2019 and 2/28/2020. |
Remarks: |
Remarks: Note: Also see attached Exhibit EX-24 Power of Attorney. |
Daniel V. Logue w/POA for John Deren | 05/11/2017 | |
** 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 5 (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 Number. |