-----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, OV7gBCnYC5rTHRO+SnYdWrulgmSw3A/n8NbURI+CDWteIWPXRpITSvEA884Bih7N ZPSPY+VKDdylHXzjFVSgyw== 0000931731-00-000020.txt : 20000211 0000931731-00-000020.hdr.sgml : 20000211 ACCESSION NUMBER: 0000931731-00-000020 CONFORMED SUBMISSION TYPE: SC 13G/A PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20000210 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: MERIT MEDICAL SYSTEMS INC CENTRAL INDEX KEY: 0000856982 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 870447695 STATE OF INCORPORATION: UT FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G/A SEC ACT: SEC FILE NUMBER: 005-45861 FILM NUMBER: 530804 BUSINESS ADDRESS: STREET 1: 1600 WEST MERIT PARK WAY CITY: SOUTH JORDAN STATE: UT ZIP: 84095 BUSINESS PHONE: 8012531600 MAIL ADDRESS: STREET 1: 1600 WEST MERIT PARKWAY CITY: SOUTH JORDAN STATE: UT ZIP: 84095 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: LAMPROPOULOS FRED P CENTRAL INDEX KEY: 0000901534 STANDARD INDUSTRIAL CLASSIFICATION: [] IRS NUMBER: 870447694 FILING VALUES: FORM TYPE: SC 13G/A BUSINESS ADDRESS: STREET 1: 1600 W MARIT PARKWAY CITY: SO JORDAN STATE: UT ZIP: 84095 BUSINESS PHONE: 84095-1688 SC 13G/A 1 OMB APPROVAL ----------------------------------------------- OMB Number 3235-0145 Expire August 31, 1999 Estimated average burden hours per response........................14.90 UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 SCHEDULE 13G/A Under the Securities Exchange Act of 1934 (Amendment No. 9 )* ------- Merit Medical Systems, Inc. (Name of Issuer) Common Stock, No Par Value (Title of Class of Securities) 589889-10-4 ------------- (CUSIP Number) December 31, 1999 ----------------------------------------- (Date of Event Which Requires Filing of this Statement) Check the appropriate box to designate the rule pursuant to which this Schedule is filed: [ ] Rule 13d-1(b) [ ] Rule 13d-1(c) [X] Rule 13d-1(d) *The remainder of this cover page shall be filled out for a reporting person's initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter the disclosures provided in a prior cover page. The information required in the remainder of this cover page shall not be deemed to be "filed" for the purpose of Section 18 of the Securities Exchange Act of 1934 ("Act") or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes). Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. 1 CUSIP No. 589889-10-4 - ----------------------- - -------------------------------------------------------------------------------- 1. Names of Reporting Persons. I.R.S. Identification Nos. of above persons (entities only). Fred P. Lampropoulos -------------------- - -------------------------------------------------------------------------------- 2. Check the Appropriate Box if a Member of a Group (See Instructions) (a) [ ] (b) [ ] - -------------------------------------------------------------------------------- 3. SEC Use Only - -------------------------------------------------------------------------------- 4. Citizenship or Place of Organization United States - -------------------------------------------------------------------------------- Number of 5. Sole Voting Power 679,541 ------- Shares Bene- ficially 6. Shared Voting Power None ---- Owned by Each Reporting 7. Sole Dispositive Power 679,541 ------- Person With: 8. Shared Dispositive Power None ---- - -------------------------------------------------------------------------------- 9. Aggregate Amount Beneficially Owned by Each Reporting Person 679,541 ------- 10. Check if the Aggregate Amount in Row (9) Excludes Certain Shares (See Instructions) [ ] 11. Percent of Class Represented by Amount in Row (9) 8.9 % ----- 12. Type of Reporting Person (See Instructions) IN -- 2 CUSIP No. 589889-10-4 Item 1. (a) Name of Issuer: Merit Medical Systems, Inc. (the "Company") (b) Address of Issuer's Principal Executive Offices: 1600 West Merit Parkway, South Jordan, Utah 84095 Item 2. (a) Name of Person Filing: Fred P. Lampropoulos (the "Reporting Person") (b) Address of Principal Business Office, if none, Residence: 1600 West Merit Parkway, South Jordan, Utah 84095 (c) Citizenship: United States (d) Title of Class of Securities: Common Stock, No Par Value (the "Common Stock") (e) CUSIP Number: 589889-10-4 Item 3. This statement is not filed pursuant to Sections 240.13d-1(b) or 240.13d-2(b) or (c). Item 4. Ownership (a) Amount Beneficially Owned: The Reporting Person is the beneficial owner of 679,541 shares of the Common Stock, which includes 13,194 shares owned by the Reporting Person pursuant to the Issuer's 401(k) Plan, based upon the most recent plan statement timely distributed, and 146,000 shares that the Reporting Person has the right to acquire pursuant to options that are currently exercisable or exercisable within the next sixty (60) days. (b) Percent of Class: 8.9% (c) Number of shares as to which the Reporting Person has: (i) sole power to vote or to direct the vote: 679,541 (ii) shared power to vote or to direct the vote: None (iii) sole power to dispose or to direct the disposition of: 679,541 (iv) shared power to dispose or to direct the disposition of: None Item 5. Ownership of Five Percent or Less of a Class This statement is not being filed to report the fact that as of the date hereof the Reporting Person has ceased to be the beneficial owner of more than five percent of the class of securities. Item 6. Ownership of More than Five Percent on Behalf of Another Person Not applicable. Item 7. Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on By the Parent Holding Company Not applicable. 3 Item 8. Identification and Classification of Members of the Group Not applicable. Item 9. Notice of Dissolution of Group Not applicable. Item 10. Certification Not applicable. 4 SIGNATURE After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct. 2/07/2000 --------- Date /s/ FRED P. LAMPROPOLOUS ------------------------ Signature Fred P. Lampropoulos -------------------- Name/Title 5 -----END PRIVACY-ENHANCED MESSAGE-----