0001127602-16-052198.txt : 20160513
0001127602-16-052198.hdr.sgml : 20160513
20160513172710
ACCESSION NUMBER: 0001127602-16-052198
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20160511
FILED AS OF DATE: 20160513
DATE AS OF CHANGE: 20160513
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: Zakrzewski Joseph S
CENTRAL INDEX KEY: 0001331852
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-33462
FILM NUMBER: 161649679
MAIL ADDRESS:
STREET 1: 110 ALLEN ROAD
CITY: LIBERTY CORNER
STATE: NJ
ZIP: 07938
4
1
form4.xml
PRIMARY DOCUMENT
X0306
4
2016-05-11
0001145197
INSULET CORP
PODD
0001331852
Zakrzewski Joseph S
C/O INSULET CORPORATION
600 TECHNOLOGY PARK DRIVE, SUITE 200
BILLERICA
MA
01821
1
Common Stock
2016-05-11
4
A
0
3810
0
A
27849
D
Stock Option (Right to Buy)
28.87
2016-05-11
4
A
0
5235
0
A
2017-04-30
2026-05-11
Common Stock
5235
5235
D
The 3,810 restricted stock units vest 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.
Includes 1,000 restricted stock units granted on June 2, 2014, which vest on April 30, 2017; and 2,020 restricted stock units granted on May 13, 2015, which vest 50% of the total units on April 30, 2017 and 50% 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 practiable following a vesting date.
/s/ David Colleran, attorney-in-fact
2016-05-13