0001127602-16-064786.txt : 20161014 0001127602-16-064786.hdr.sgml : 20161014 20161014084922 ACCESSION NUMBER: 0001127602-16-064786 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20161012 FILED AS OF DATE: 20161014 DATE AS OF CHANGE: 20161014 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: INSULET CORP CENTRAL INDEX KEY: 0001145197 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 043523891 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 600 TECHNOLOGY PARK STREET 2: SUITE 200 CITY: BILLERICA STATE: MA ZIP: 01821 BUSINESS PHONE: 978-600-7000 MAIL ADDRESS: STREET 1: 600 TECHNOLOGY PARK STREET 2: SUITE 200 CITY: BILLERICA STATE: MA ZIP: 01821 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SULLIVAN PATRICK J CENTRAL INDEX KEY: 0001039138 STATE OF INCORPORATION: MA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33462 FILM NUMBER: 161936033 MAIL ADDRESS: STREET 1: 85 SWANSON ROAD STREET 2: . CITY: BOXBOROUGH STATE: MA ZIP: 01719 4 1 form4.xml PRIMARY DOCUMENT X0306 4 2016-10-12 0001145197 INSULET CORP PODD 0001039138 SULLIVAN PATRICK J C/O INSULET CORPORATION 600 TECHNOLOGY PARK DRIVE, SUITE 200 BILLERICA MA 01821 1 1 President & CEO Common Stock 2016-10-12 4 M 0 3075 32.51 A 221544 D Employee Stock Option (Right to Buy) 32.51 2016-10-12 4 M 0 3075 0 D 2025-03-02 Common Stock 3075 59110 D 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. 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. 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. 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. /s/ David Colleran, attorney-in-fact 2016-10-14