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