0001127602-15-017689.txt : 20150518
0001127602-15-017689.hdr.sgml : 20150518
20150518165846
ACCESSION NUMBER: 0001127602-15-017689
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20150513
FILED AS OF DATE: 20150518
DATE AS OF CHANGE: 20150518
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: Fallon John A.
CENTRAL INDEX KEY: 0001560152
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-33462
FILM NUMBER: 15873902
MAIL ADDRESS:
STREET 1: C/O INSULET CORPORATION
STREET 2: 9 OAK PARK DRIVE
CITY: BEDFORD
STATE: MA
ZIP: 01730
4
1
form4.xml
PRIMARY DOCUMENT
X0306
4
2015-05-13
0001145197
INSULET CORP
PODD
0001560152
Fallon John A.
C/O INSULET CORPORATION
600 TECHNOLOGY PARK DRIVE, SUITE 200
BILLERICA
MA
01821
1
Common Stock
2015-05-13
4
A
0
4039
0
A
12039
D
Stock Option (Right to Buy)
27.37
2015-05-13
4
A
0
5525
0
A
2025-05-13
Common Stock
5525
5525
D
The 4,039 restricted stock units vest 50% of the total units on April 30, 2016, 25% of the total units on April 30, 2017 and 25% 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 practicable following a vesting date.
Includes 1,000 restricted stock units granted on June 3, 2013 which vest on April 30, 2016; and 2,000 restricted stock units granted on June 2, 2014, which vest 50% of the total units on April 30, 2016 and 50% of the total units on April 30, 2017, subject to continued service as a director or consultant. Vested shares will be delivered to the reporting person as soon as practicable following a vesting date.
This option is subject to a three-year vesting period with 50% of the total award vesting on April 30, 2016, 25% of the total award vesting on April 30, 2017 and 25% of the total award vesting on April 30, 2018, subject to continued service as a director or consultant.
/s/ R. Anthony Diehl, attorney in fact
2015-05-18