0001127602-18-010424.txt : 20180306 0001127602-18-010424.hdr.sgml : 20180306 20180306194517 ACCESSION NUMBER: 0001127602-18-010424 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20180302 FILED AS OF DATE: 20180306 DATE AS OF CHANGE: 20180306 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: 18671575 MAIL ADDRESS: STREET 1: 85 SWANSON ROAD STREET 2: . CITY: BOXBOROUGH STATE: MA ZIP: 01719 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 4 1 form4.xml PRIMARY DOCUMENT X0306 4 2018-03-02 0001145197 INSULET CORP PODD 0001039138 SULLIVAN PATRICK J C/O INSULET CORPORATION 600 TECHNOLOGY PARK DRIVE, SUITE 200 BILLERICA MA 01821 1 1 CEO and Chairman of the Board Common Stock 2018-03-02 4 F 0 6468 73.07 D 257852 D Common Stock 100000 I By Grantor Retained Annuity Trust This transaction represents the withholding of shares received upon the vesting of restricted stock units to cover the associated tax obligations. Includes 15,216 performance share units granted on April 1, 2015, which vest on April 1, 2018; 14,240 restricted stock units granted on February 24, 2016, which vest on February 24, 2019; 12,022 restricted stock units granted on February 22, 2017, which vest one-half of the total units on February 22, 2019 and one-half of the total units on February 22, 2020; 51,266 performance share units granted on February 24, 2016, which vest on February 24, 2019; and 12,081 restricted stock units granted on February 14, 2018, which vest as to one-third of the total units on February 14, 2019, one-third of the total units on February 14, 2020 and one-third of the total units on February 14, 2021. Vested shares will be delivered to the reporting person as soon as practicable following a vesting date. Includes an aggregate of 2,213 shares acquired under the Insulet Corporation 2007 Employee Stock Purchase Plan on the following dates: 777 shares on December 31, 2015, 674 shares acquired on June 30, 2016 and 762 shares acquired on May 31, 2017. /s/ David Colleran, attorney-in-fact 2018-03-06