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