0001127602-23-010446.txt : 20230316 0001127602-23-010446.hdr.sgml : 20230316 20230316162650 ACCESSION NUMBER: 0001127602-23-010446 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230315 FILED AS OF DATE: 20230316 DATE AS OF CHANGE: 20230316 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: 23739178 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 2023-03-15 0001145197 INSULET CORP PODD 0001631895 Petrovic Shacey C/O INSULET CORPORATION 100 NAGOG PARK ACTON MA 01720 1 1 Advisor Common Stock 2023-03-15 5 G 0 E 12925 0 D 7863 D Common Stock 2023-03-15 5 G 0 E 12925 0 A 12925 I By SP Trust Common Stock 58205 I By NG Trust On March 15, 2023, the reporting person transferred 12,925 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/ Patricia K. Dolan, attorney-in-fact 2023-03-16