-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, VQiJrtyvhAJ6e3LTExsurK7Jnny15QBhC8GFor8XdICCWY9XyAmGunh3N2nsvjVE LEoEOmavdvzXvfNy/6DNsA== 0000064670-02-000058.txt : 20020819 0000064670-02-000058.hdr.sgml : 20020819 20020816181037 ACCESSION NUMBER: 0000064670-02-000058 CONFORMED SUBMISSION TYPE: 3/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20020427 FILED AS OF DATE: 20020819 COMPANY DATA: COMPANY CONFORMED NAME: WARD SCOTT R CENTRAL INDEX KEY: 0001174531 OFFICER FILING VALUES: FORM TYPE: 3/A BUSINESS ADDRESS: STREET 1: METRONIC INC STREET 2: 710 MEDTRONIC PARKWAY MS LC310 CITY: MINNEAPOLIS STATE: MN ZIP: 55432-5604 BUSINESS PHONE: 7635144000 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: MEDTRONIC INC CENTRAL INDEX KEY: 0000064670 STANDARD INDUSTRIAL CLASSIFICATION: ELECTROMEDICAL & ELECTROTHERAPEUTIC APPARATUS [3845] IRS NUMBER: 410793183 STATE OF INCORPORATION: MN FISCAL YEAR END: 0430 FILING VALUES: FORM TYPE: 3/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-07707 FILM NUMBER: 02741838 BUSINESS ADDRESS: STREET 1: 710 MEDTRONIC PKWY STREET 2: MS LC300 CITY: MINNEAPOLIS STATE: MN ZIP: 55432 BUSINESS PHONE: 7635144000 3/A 1 wardform3amend.txt SCOTT WARD FORM 3 AMENDED 1. Name and Address of Reporting Person Ward, Scott R. Medtronic, Inc. 710 Medtronic Pkwy Minneapolis, MN 55432- 2. Date of Event Requiring Statement (Month/Day/Year) 04/27/2002 3. IRS or Social Security Number of Reporting Person (Voluntary) 4. Issuer Name and Ticker or Trading Symbol Medtronic, Inc. (MDT) 5. Relationship of Reporting Person(s) to Issuer (Check all applicable) ( ) Director ( ) 10% Owner (X) Officer (give title below) ( ) Other (specify below) Sr. Vice President & President, Neuro & Diabetes 6. If Amendment, Date of Original (Month/Day/Year) 05/06/2002 7. Individual or Joint/Group Filing (Check Applicable Line) (X) Form filed by One Reporting Person ( ) Form filed by More than One Reporting Person TABLE I -- Non-Derivative Securities Beneficially Owned
+------------------------------------------+----------------------+----------------+-----------------------------------------------+ |1. Title of Security |2. Amount of |3. Ownership |4. Nature of Indirect Beneficial Ownership | | | Securities | Form: | | | | Beneficially Owned | Direct(D) or | | | | | Indirect(I) | | +------------------------------------------+----------------------+----------------+-----------------------------------------------+ Common Stock 21679.855 D Common Stock 4274.386 I By ESOP Common Stock 6310 I By Wife Common Stock 1595.42 I By 401(k)
TABLE II -- Derivative Securities Beneficially Owned
+-----------------------+---------------------+---------------------------------+----------+-------------+-------------------------+ |1.Title of Derivative |2.Date Exercisable |3.Title and Amount of Securities |4.Conver- |5.Ownership |6. Nature of Indirect | | Security | and Expiration Date| Underlying Derivative | sion or | Form of | Beneficial Ownership | | | (Month/Day/Year) | Security | Exercise | Derivative | | | +----------+----------+-----------------------+---------+ Price of | Security: | | | | Date | Expira- | |Amount or| Deri- | Direct(D) or| | | | Exer- | tion | Title |Number of| vative | Indirect(I) | | | | cisable | Date | |Shares | Security | | | +-----------------------+----------+----------+-----------------------+---------+----------+-------------+-------------------------+ Stock Options (Right to 11/30/1996 11/30/2005 Common Stock 4436 $13.5313 D buy) Stock Options (Right to 11/20/1997 11/20/2006 Common Stock 5852 $17.0938 D buy) Stock Options (Right to 10/29/1998 10/29/2007 Common Stock 6958 $21.5625 D buy) Stock Options (Right to 10/28/1999 10/28/2008 Common Stock 7836 $31.9063 D buy) Stock Options (Right to 10/27/2000 10/27/2009 Common Stock 30189 $33.125 D buy) Stock Options (Right to 04/28/2007 04/28/2009 Common Stock 2214 $37.5938 D buy) Stock Options (Right to 10/25/2002 10/25/2011 Common Stock 32184 $43.5 D buy) Stock Options (Right to 04/26/2002 04/26/2012 Common Stock 8793 $43.81 D buy) Stock Options (Right to 04/26/2002 04/26/2012 Common Stock 2740 $43.81 D buy) Stock Options (Right to 10/26/2001 10/26/2010 Common Stock 22277 $51.625 D buy) Right to Receive Stock Common Stock 427.21 $0 D Explanation of Responses: These options become exercisable at the rate of 25% of the shares granted per year beginning on the first anniversary of grant. Rights acquired under the Medtronic, Inc. Executive Non-qualified Supplemental Benefit Plan to be settled in Medtronic common stock as a 1-for-1 conversion upon the employee's retirement or other termination of employment.
SIGNATURE OF REPORTING PERSON /s/ Scott R. Ward DATE 08/14/2002 -----END PRIVACY-ENHANCED MESSAGE-----