-----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, IU0+/XEvccLeJVS8QNV0t+Qa33BU5Il8eivgwZPF0dZJ0WBzMo3EPsCBGZa1FtQc eP5jhlU/0dtHueO0D2Vh9g== 0000064670-02-000088.txt : 20020911 0000064670-02-000088.hdr.sgml : 20020911 20020911163417 ACCESSION NUMBER: 0000064670-02-000088 CONFORMED SUBMISSION TYPE: 4/A PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20020828 FILED AS OF DATE: 20020911 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/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-07707 FILM NUMBER: 02761811 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: COLLINS ARTHUR D JR CENTRAL INDEX KEY: 0001038253 RELATIONSHIP: OFFICER FILING VALUES: FORM TYPE: 4/A BUSINESS ADDRESS: STREET 1: 710 MEDTRONIC PKWY MS LC310 CITY: MINNEAPOLIS STATE: MN ZIP: 55432-5604 BUSINESS PHONE: 7635144000 MAIL ADDRESS: STREET 1: 7000 CENTRAL AVE NE CITY: MINNEAPOLIS STATE: MN ZIP: 55432 4/A 1 collins0802form4amend.txt ARTHUR COLLINS AMENDED AUG 02 FORM 4 1. Name and Address of Reporting Person Collins, Jr., Arthur D. Medtronic, Inc. 710 Medtronic Pkwy Minneapolis, MN 55432- 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 R1 5. If Amendment, Date of Original (Month/Day/Year) 09/10/2002 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) (X) Director ( ) 10% Owner (X) Officer (give title below) ( ) Other (specify below) Chairman of the Board and Chief Executive Officer 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 08/10/2002 M 6516.854 A $0.0000 D Common Stock 08/10/2002 F -6516.854 D $41.4000 454411.876 D Common Stock 24808.039 I By 401(k) Plan Common Stock 4203.713 I By ESOP
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 08/10/2002 M 6516. Common 6516.854 $0.0000 296376.8 D Receive Stock 854 Stock 88 Explanation of Responses: This amendment is to correct an error discovered in the amount of derivative securities beneficially owned at the end of the reporting period. The total originally reported was higher than the amount of such securities owned by Mr. Collins. Based on a plan statement as of July 31, 2002. On August 10, 2002, the right to receive stock under this award vested and the executive is now entitiled to receive 296,376.888 shares and dividend equivalents upon his retirement from the company. The remaining 6516.854 units were converted to shares and withheld from this award to cover FICA and related Federal and State taxes due at vesting.
SIGNATURE OF REPORTING PERSON /s/ Carol E. Malkinson, Attorney-in-fact ______________________ Arthur D. Collins, Jr. DATE 09/11/2002 EX-24 3 collinspoa.txt ARTHUR COLLINS POWER OF ATTORNEY Power of Attorney I, Arthur D. Collins, Jr., 710 Medtronic Parkway, Minneapolis, MN 55432-5604 do hereby appoint: David J. Scott, Senior Vice President, General Counsel and Corporate Secretary Medtronic, Inc., 710 Medtronic Parkway, Minneapolis, MN 55432-5604 Richard F. Hamm, Jr., Vice President and Deputy General Counsel, Medtronic, Inc., 710 Medtronic Parkway, Minneapolis, MN 55432-5604 Gary A. Nelson, Vice President, Risk Management and Legal Administrative Services Medtronic, Inc., 710 Medtronic Parkway, Minneapolis, MN 55432-5604 Carol E. Malkinson, Senior Legal Counsel and Assistant Secretary Medtronic, Inc. 710 Medtronic Parkway, Minneapolis, MN 55432- 5604 As attorney-in-fact in my name, place and stead to act individually in any way which I myself could do, if I were personally present, with respect to the filing of reports as required under Section 16(a) of the Securities Exchange Act of 1934, including Forms 3, 4 and 5, and under Rule 144 of the Securities Act of 1933. In Witness Whereof, I have hereunder set my name this 29 day of August, 2002. /s/ Arthur D. Collins, Jr. Arthur D. Collins, Jr. Specimen Signature of Attorney(s)-in-Fact /s/ David J. Scott David J. Scott /s/ Richard F. Hamm, Jr. Richard F. Hamm, Jr. /s/ Gary A. Nelson Gary A. Nelson /s/ Carol E. Malkinson Carol E. Malkinson STATE OF MINNESOTA ) COUNTY OF ANOKA ) The foregoing instrument was acknowledged before me this 29 day of August, 2002. /s/ Sonja S. Bornus Sonja S. Bornus -----END PRIVACY-ENHANCED MESSAGE-----