0001127602-19-000681.txt : 20190103 0001127602-19-000681.hdr.sgml : 20190103 20190103162241 ACCESSION NUMBER: 0001127602-19-000681 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190102 FILED AS OF DATE: 20190103 DATE AS OF CHANGE: 20190103 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Petrovic Shacey CENTRAL INDEX KEY: 0001631895 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33462 FILM NUMBER: 19505793 MAIL ADDRESS: STREET 1: 600 TECHNOLOGY PARK DRIVE STREET 2: SUITE 200 CITY: BILLERICA STATE: MA ZIP: 01821 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: 100 NAGOG PARK CITY: ACTON STATE: MA ZIP: 01720 BUSINESS PHONE: 978-600-7000 MAIL ADDRESS: STREET 1: 100 NAGOG PARK CITY: ACTON STATE: MA ZIP: 01720 4 1 form4.xml PRIMARY DOCUMENT X0306 4 2019-01-02 0001145197 INSULET CORP PODD 0001631895 Petrovic Shacey C/O INSULET CORPORATION 100 NAGOG PARK ACTON MA 01720 1 1 President and CEO Common Stock 2019-01-02 4 A 0 6809 0 A 97415 D The 6,809 restricted stock units vest one-third of the total units on January 2, 2020, and one-third of the total units on January 2, 2021, and one-third of the total units on January 2, 2022, subject to continued employment. Vested shares will be delivered to the reporting person as soon as practicable following a vesting date. Includes 9,015 restricted stock units granted on February 22, 2017, which vest as to one-half of the total units on February 22, 2019 and one-half of the total units on February 22, 2020; 7,120 restricted stock units granted on February 24, 2016, which vest on February 24, 2019; 8,544 performance share units granted on February 24, 2016, which vest on February 24, 2019; and 6,711 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, subject to continued employment. Vested shares will be delivered to the reporting person as soon as practicable following a vesting date. /s/ David Colleran, attorney-in-fact 2019-01-03