0001127602-19-033199.txt : 20191119
0001127602-19-033199.hdr.sgml : 20191119
20191119161039
ACCESSION NUMBER: 0001127602-19-033199
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: Petrovic Shacey
CENTRAL INDEX KEY: 0001631895
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-33462
FILM NUMBER: 191231264
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
2019-11-15
0001145197
INSULET CORP
PODD
0001631895
Petrovic Shacey
C/O INSULET CORPORATION
100 NAGOG PARK
ACTON
MA
01720
1
1
President and CEO
Common Stock
2019-11-15
4
M
0
3417
29.26
A
97927
D
Common Stock
2019-11-15
4
F
0
554
180.22
D
97373
D
Common Stock
2019-11-15
5
G
0
E
835
0
D
96538
D
Employee Stock Option (Right to Buy)
29.26
2019-11-15
4
M
0
3417
0
D
2026-02-24
Common Stock
3417
48051
D
Constitutes previously owned shares to cover the exercise price of the option being exercised through a stock swap.
This option is subject to a four-year vesting period with 25% of the total award vesting one year after the grant date and the remainder vesting in equal quarterly installments each quarter thereafter for 12 quarters, subject to continued employment.
/s/ John W. Kapples, attorney-in-fact
2019-11-19