0001127602-20-024133.txt : 20200824 0001127602-20-024133.hdr.sgml : 20200824 20200824163640 ACCESSION NUMBER: 0001127602-20-024133 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20200811 FILED AS OF DATE: 20200824 DATE AS OF CHANGE: 20200824 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: 201128276 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 2020-08-11 0001145197 INSULET CORP PODD 0001631895 Petrovic Shacey C/O INSULET CORPORATION 100 NAGOG PARK ACTON MA 01720 1 1 President and CEO Common Stock 2020-08-11 5 G 0 E 14750 0 D 106308 D Common Stock 2020-08-19 5 G 0 E 87495 0 D 18813 D Common Stock 87495 I By Trust Includes 137 shares acquired under the Insulet Corporation Employee Stock Purchase Plan on May 29, 2020. On August 19, 2020, the reporting person transferred 87,495 shares of Insulet common stock to a family trust of which the reporting person is a trustee. The reporting person and members of her immediate family are beneficiaries of the trust. /s/ John W. Kapples, attorney-in-fact 2020-08-24