-----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, Ea8qVjVwOPJlAtKd0WFxm7HykZ8STk/0JxhRdPOPzPMr5fndX9Midjkvr1NN6dyW 4af8kpe6rrlA4nkojjniuA== 0000064670-02-000086.txt : 20020910 0000064670-02-000086.hdr.sgml : 20020910 20020910122834 ACCESSION NUMBER: 0000064670-02-000086 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20020823 FILED AS OF DATE: 20020910 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: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-07707 FILM NUMBER: 02760362 BUSINESS ADDRESS: STREET 1: 710 MEDTRONIC PKWY STREET 2: MS LC300 CITY: MINNEAPOLIS STATE: MN ZIP: 55432 BUSINESS PHONE: 7635144000 REPORTING-OWNER: COMPANY DATA: COMPANY CONFORMED NAME: CHELLGREN PAUL W CENTRAL INDEX KEY: 0001023533 RELATIONSHIP: DIRECTOR FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: PO BOX 391 CITY: ASHLAND STATE: KY ZIP: 41114 BUSINESS PHONE: 6063293333 MAIL ADDRESS: STREET 1: C/O ASHLAND INC STREET 2: 1000 ASHLAND DRIVE PO BOX 391 CITY: RUSSELL STATE: KY ZIP: 41169 4 1 chellgrenfinalform4.txt PAUL CHELLGREN FINAL FORM 4 1. Name and Address of Reporting Person Chellgren, Paul W. Ashland, Inc. 50 E RiverCenter Blvd Covington, KY 41012-0391 2. Issuer Name and Ticker or Trading Symbol Medtronic, Inc. (MDT) 3. IRS or Social Security Number of Reporting Person (Voluntary) 4. Statement for Month/Year 8/2002 5. If Amendment, Date of Original (Month/Day/Year) 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) ( ) Director ( ) 10% Owner ( ) Officer (give title below) (X) Other (specify below) Former Director 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 Acquired, Disposed of, or Beneficially Owned
+---------------------------------+----------+-------------+-----------------------------+----------------+-----------+------------+ |1. Title of Security |2. Trans- |3. Trans- |4. Securities Acquired (A) |5. Amount of |6. Owner- |7. Nature | | | action | action | or Disposed of (D) | Securities | ship | of In- | | | Date | Code | | Beneficially | Form: | direct | | | | | | Owned at | Direct | Bene- | | | (Month/ | | | End of | (D) or | ficial | | | Day/ +-------+-----+-----------+------+----------+ Month | Indirect| Owner- | | | Year) |Code |V |Amount |A/D |Price | | (I) | ship | +---------------------------------+----------+-------+-----+-----------+------+----------+----------------+-----------+------------+ Common Stock 08/23/2002 M 696.749 A $0.0000 D Common Stock 08/23/2002 M 567.922 A $0.0000 D Common Stock 08/23/2002 M 670.533 A $0.0000 D Common Stock 08/23/2002 M 15.936 A $0.0000 D Common Stock 08/23/2002 M 725.86 A $0.0000 4677 D
TABLE II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned
+-------------+--------+----------+---------+-----------+---------------------+----------------+----------+--------+-------+-------+ |1. |2. |3. |4. |5. |6. |7. |8. |9. |10. |11. | | | | | | | | | |Number |Owner- | | | | | | | | | | |of |ship | | | | | | | | | | |Deriv- |Form of| | | | | | | | |Title and Amount| |ative |Deriv- | | | | | | | | |of Underlying | |Secur- |ative |Nature | | |Conver- | | |Number of | |Securities | |ities |Secur- |of | | |sion or | | |Derivative |Date Exercisable +-------+--------+ |Benefi- |ity: |In- | | |Exercise| | |Securities |and Expiration Date | |Amount | |cially |Direct |direct | | |Price of|Transac- |Transac- |Acquired(A)|(Month/Day/Year) | |or | |Owned |(D) or |Bene- | |Title of |Deriv- |tion Date |tion Code|Disposed(D)+----------+----------+ |Number |Price of |at End |In- |ficial | |Derivative |ative |(Month/ +------+--+-----+-----+Date Exer-|Expira- | |of |Derivative|of |direct |Owner- | |Security |Security|Day/Year) |Code |V |(A) |(D) |cisable |tion Date |Title |Shares |Security |Month |(I) |ship | +-------------+--------+----------+------+--+-----+-----+----------+----------+-------+--------+----------+--------+-------+-------+ Right to $0 08/23/2002 M 567.9 Common 567.922 $0.0000 0 D Receive Stock 22 Stock Right to $0 08/23/2002 M 670.5 Common 670.533 $0.0000 0 D Receive Stock 33 Stock Right to $0 08/23/2002 A 15.48 Common 15.489 $0.0000 D Receive Stock 9 Stock Right to $0 08/23/2002 M 15.48 Common 15.489 $0.0000 0 D Receive Stock 9 Stock Right to $0 08/23/2002 M 696.7 Common 696.749 $0.0000 D Receive Stock 49 Stock Right to $0 08/23/2002 M 725.8 Common 725.86 $0.0000 0 D Receive Stock 6 Stock Explanation of Responses: Deferred units credited under the Medtronic, Inc. Outside Director's Compensation Plan to be paid in Medtronic common stock upon the director's resignation or retirement.
SIGNATURE OF REPORTING PERSON /s/ Carol E. Malkinson, Attorney-in-fact _________________ Paul W. Chellgren DATE 09/06/2002 -----END PRIVACY-ENHANCED MESSAGE-----