0001127602-19-033198.txt : 20191119
0001127602-19-033198.hdr.sgml : 20191119
20191119160837
ACCESSION NUMBER: 0001127602-19-033198
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20191115
FILED AS OF DATE: 20191119
DATE AS OF CHANGE: 20191119
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: 191231228
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
2019-11-15
0001145197
INSULET CORP
PODD
0001560152
Fallon John A.
C/O INSULET CORPORATION
100 NAGOG PARK
ACTON
MA
01720
1
Common Stock
2019-11-15
4
M
0
5000
21.35
A
18469
D
Common Stock
2019-11-15
4
S
0
5000
180.065
D
13469
D
Common Stock
2019-11-18
4
M
0
5525
27.37
A
18994
D
Common Stock
2019-11-18
4
M
0
4000
30.04
A
22994
D
Common Stock
2019-11-18
4
S
0
9525
181.4087
D
13469
D
Stock Option (Right to Buy)
21.35
2019-11-15
4
M
0
5000
0
D
2022-11-01
Common Stock
5000
0
D
Stock Option (Right to Buy)
27.37
2019-11-18
4
M
0
5525
0
D
2025-05-13
Common Stock
5525
0
D
Stock Option (Right to Buy)
30.04
2019-11-18
4
M
0
4000
0
D
2023-06-03
Common Stock
4000
0
D
The price reported represents the weighted average sale price of the shares sold. The shares were sold at varying prices in the range of $181.18 to $182.82. The Reporting Person hereby undertakes, upon request of the Staff of the U.S. Securities Exchange Commission, the Issuer or a security holder of the Issuer, to provide full information regarding the number of shares sold at each separate price.
This option is subject to a three-year vesting period with 50% of the total award vesting on the first anniversary of the date of grant and 25% of the total award vesting on each of the second and third anniversaries of the date of grant, subject to continued service as a director or consultant.
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.
This option is subject to the following vesting schedule: 50% of the total award shall vest on April 30, 2014, 25% of the total award shall vest on April 30, 2015 and 25% of the total award shall vest on April 30, 2016, subject to continued service as a director or consultant.
/s/ John W. Kapples, attorney-in-fact
2019-11-19