0001127602-20-007335.txt : 20200224 0001127602-20-007335.hdr.sgml : 20200224 20200224171254 ACCESSION NUMBER: 0001127602-20-007335 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20200221 FILED AS OF DATE: 20200224 DATE AS OF CHANGE: 20200224 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: 20645453 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 2020-02-21 0001145197 INSULET CORP PODD 0001631895 Petrovic Shacey C/O INSULET CORPORATION 100 NAGOG PARK ACTON MA 01720 1 1 President and CEO Common Stock 2020-02-21 4 A 0 43272 0 A 143237 D Common Stock 2020-02-21 4 F 0 21192 212.31 D 122045 D The Performance Share Units ("PSUs") were granted on February 22, 2017, and the Compensation Committee of the Board of Directors determined on February 21, 2020 that the PSUs were earned based on the performance of the Company. The PSUs vest in full on the later of the date of determination by the Compensation Committee or the third anniversary of the date of grant and are settled in shares of common stock on a one-for-one basis. This transaction represents the withholding of shares upon the vesting of restricted stock units and performance share units to cover the associated tax obligations. /s/ John W. Kapples, attorney-in-fact 2020-02-24