0001127602-19-020531.txt : 20190603
0001127602-19-020531.hdr.sgml : 20190603
20190603173756
ACCESSION NUMBER: 0001127602-19-020531
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 2
CONFORMED PERIOD OF REPORT: 20190530
FILED AS OF DATE: 20190603
DATE AS OF CHANGE: 20190603
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: 19874493
MAIL ADDRESS:
STREET 1: C/O INSULET CORPORATION
STREET 2: 9 OAK PARK DRIVE
CITY: BEDFORD
STATE: MA
ZIP: 01730
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
2019-05-30
0001145197
INSULET CORP
PODD
0001560152
Fallon John A.
C/O INSULET CORPORATION
100 NAGOG PARK
ACTON
MA
01720
1
Common Stock
2019-05-30
4
A
0
1726
0
A
13469
D
Annual equity award in the form of restricted stock units ("RSUs"). RSUs vest in full on April 30, 2020 and are settled in shares of common stock on a one-for-one basis.
/s/ John W. Kapples, attorney-in-fact
2019-06-03
EX-24
2
doc1.txt
POWER OF ATTORNEY (PUBLIC): POA
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS, that the undersigned hereby
constitutes and appoints Shacey Petrovic, John W. Kapples, Wayde D.
McMillan and Keith Bilezerian, and any one of them acting singly, the
true and lawful attorneys-in-fact and agents, with full power of
substitution and resubstitution, for the undersigned and in the
undersigned's name, place and stead, in any and all capacities (until
revoked in writing) to execute for and on behalf of the undersigned, in any
any and all of the undersigned's capacities any and all statements on
Forms 3, 4 and 5 with respect to the undersigned's holdings of and
transactions in securities issued by Insulet Corporation (the "Company")
in accordance with Sections 16(a) of the Securities Exchange Act of 1934,
as amended (the "Exchange Act"), and any and all regulations promulgated
thereunder, and to file the same, with all exhibits thereto, and any other
documents in connection therewith, with the Securities and Exchange
Commission, and with any other entity when and if such is mandated by the
Exchange Act or by the By-laws of the National Association of Securities
Dealers, granting unto said attorneys-in-fact and agents full power and
authority to do and perform each and every act and thing requisite and
necessary fully to all intents and purposes as the undersigned might or
could do in person thereby ratifying and confirming all that said
attorneys-in-fact and agents, or their substitute or substitutes, may lawfully
do or cause to be done by virtue hereof.
This Power of Attorney shall remain in full force and effect until the
undersigned is no longer required to file Forms 3, 4 and 5 with respect to
the undersigned's holdings of and transactions in securities issued by the
Company, unless earlier revoked by the undersigned in a signed writing
delivered to the foregoing attorneys-in-fact.
IN WITNESS WHEREOF, this Power of Attorney has been signed as of
March 26, 2019.
Signature: /s/ John A. Fallon, MD
Name: John A. Fallon, MD