0001179110-16-033104.txt : 20161216 0001179110-16-033104.hdr.sgml : 20161216 20161216162144 ACCESSION NUMBER: 0001179110-16-033104 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20161214 FILED AS OF DATE: 20161216 DATE AS OF CHANGE: 20161216 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ST JUDE MEDICAL INC CENTRAL INDEX KEY: 0000203077 STANDARD INDUSTRIAL CLASSIFICATION: ELECTROMEDICAL & ELECTROTHERAPEUTIC APPARATUS [3845] IRS NUMBER: 411276891 STATE OF INCORPORATION: MN FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: ONE ST JUDE MEDICAL DRIVE CITY: ST PAUL STATE: MN ZIP: 55117 BUSINESS PHONE: 6517562000 MAIL ADDRESS: STREET 1: ONE ST JUDE MEDICAL DRIVE CITY: ST PAUL STATE: MN ZIP: 55117 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Carlson Mark CENTRAL INDEX KEY: 0001585645 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-12441 FILM NUMBER: 162056556 MAIL ADDRESS: STREET 1: ONE ST. JUDE MEDICAL DRIVE CITY: ST. PAUL STATE: MN ZIP: 55117 4 1 edgar.xml FORM 4 - X0306 4 2016-12-14 0 0000203077 ST JUDE MEDICAL INC STJ 0001585645 Carlson Mark ONE ST. JUDE MEDICAL DRIVE ST. PAUL MN 55117 0 1 0 0 Chief Medical Off-VP,Clinical Common Stock 2016-12-14 4 M 0 14200 30.58 A 22654 D Common Stock 2016-12-14 4 F 0 8735 79.76 D 13919 D Stock Options (Right to Buy) 30.58 2016-12-14 4 M 0 14200 0 D 2009-12-15 2016-12-15 Common Stock 14200 0 D Shares of common stock withheld to pay the exercise price of the stock options and to pay tax withholdings. The 14,200 shares acquired upon the option exercise, net of 8,735 shares used to pay exercise price and taxes, resulted in 5,465 shares that were retained. Fully vested at the time of filing. /s/ Kashif Rashid, Attorney in Fact 2016-12-16