0001127602-22-008265.txt : 20220304 0001127602-22-008265.hdr.sgml : 20220304 20220304162033 ACCESSION NUMBER: 0001127602-22-008265 CONFORMED SUBMISSION TYPE: 4/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220228 FILED AS OF DATE: 20220304 DATE AS OF CHANGE: 20220304 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Petrovic Shacey CENTRAL INDEX KEY: 0001631895 FILING VALUES: FORM TYPE: 4/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-33462 FILM NUMBER: 22714325 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/A 1 form4a.xml PRIMARY DOCUMENT X0306 4/A 2022-02-28 2022-03-02 0001145197 INSULET CORP PODD 0001631895 Petrovic Shacey C/O INSULET CORPORATION 100 NAGOG PARK ACTON MA 01720 1 1 President and CEO Common Stock 2022-02-28 4 A 0 6347 0 A 33510 D Common Stock 61259 I By NG Trust Common Stock 6401 I By SP Trust Employee Stock Option (Right to Buy) 264.69 2022-02-28 4 A 0 17473 0 A 2032-02-28 Common Stock 17473 17473 D Annual Restricted Stock Unit ("RSU") award. RSUs vest in equal installments on each of the first, second and third anniversaries of the grant date and are settled in shares of common stock on a one-for-one basis. Due to an administrative error, this grant was originally reported as 7,933 RSUs rather than 6,347 RSUs. Due to an administrative error, this grant was originally reported as an option to purchase 21,842 shares rather than an option to purchase 17,473 shares. Annual Non-Qualified Stock Option ("Option") Award. The Options become exercisable in substantially equal installments on each of the first, second, third and fourth anniversaries of the grant date. /s/ John W. Kapples, attorney-in-fact 2022-03-04