0001437749-23-019426.txt : 20230705 0001437749-23-019426.hdr.sgml : 20230705 20230705192137 ACCESSION NUMBER: 0001437749-23-019426 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230701 FILED AS OF DATE: 20230705 DATE AS OF CHANGE: 20230705 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Cunniff James L. CENTRAL INDEX KEY: 0001983687 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34839 FILM NUMBER: 231071529 MAIL ADDRESS: STREET 1: 500 SIXTH AVE NW CITY: NEW PRAGUE STATE: MN ZIP: 56071 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Electromed, Inc. CENTRAL INDEX KEY: 0001488917 STANDARD INDUSTRIAL CLASSIFICATION: ELECTROMEDICAL & ELECTROTHERAPEUTIC APPARATUS [3845] IRS NUMBER: 411732920 FISCAL YEAR END: 0630 BUSINESS ADDRESS: STREET 1: 500 SIXTH AVENUE NW CITY: NEW PRAGUE STATE: MN ZIP: 56071 BUSINESS PHONE: 952-758-9299 MAIL ADDRESS: STREET 1: 500 SIXTH AVENUE NW CITY: NEW PRAGUE STATE: MN ZIP: 56071 4 1 rdgdoc.xml FORM 4 X0407 4 2023-07-01 0001488917 Electromed, Inc. ELMD 0001983687 Cunniff James L. 500 SIXTH AVENUE NW NEW PRAGUE MN 56071 1 1 CEO and President 0 Employee Stock Option (right to buy) 10.71 2023-07-01 4 A 0 175000 0 A 2033-06-30 Common Stock 175000 175000 D Performance Stock Units 2023-07-01 4 A 0 87500 0 A 2027-06-30 Common Stock 87500 87500 D Performance Stock Units 2023-07-01 4 A 0 87500 0 A 2027-06-30 Common Stock 87500 87500 D Exercisable with respect to 43,750 shares on September 30, 2024, and in twelve substantially equal increments on the last day of each subsequent quarter. Each performance stock unit represents a contingent right to receive one share of common stock upon achieving a total shareholder return in excess of 50% as of the end of any fiscal quarter on or before the expiration date, calculated using three-month volume-weighted average closing prices in accordance with the underlying agreement. Each performance stock unit represents a contingent right to receive one share of common stock upon achieving a total shareholder return in excess of 100% as of the end of any fiscal quarter on or before the expiration date, calculated using three-month volume-weighted average closing prices in accordance with the underlying agreement. /s/ Joshua L. Colburn, Attorney-in-Fact 2023-07-05