-----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, RlN0GhS4A0UFg3uj/Q1xaTxnvAOsumXyMmA8RTFXcUW9NwPcT/d97GUCxUjmu64q woLmyJCmFJsO6F8cZGBA7A== 0000931731-03-000222.txt : 20030702 0000931731-03-000222.hdr.sgml : 20030702 20030702171722 ACCESSION NUMBER: 0000931731-03-000222 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20030630 FILED AS OF DATE: 20030702 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: STILLABOWER MICHAEL E CENTRAL INDEX KEY: 0001192955 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-18592 FILM NUMBER: 03772873 BUSINESS ADDRESS: STREET 1: C/O MERIT MEDICAL SYSTEMS INC STREET 2: 1600 W MERIT PARKWAY CITY: SOUTH JORDAN STATE: UT ZIP: 84095 BUSINESS PHONE: 8012531600 ISSUER: 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 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 4 1 form4-stillabower063003_ex.xml X0101 4 2003-06-30 0000856982 MERIT MEDICAL SYSTEMS INC MMSI 0001192955 STILLABOWER MICHAEL E 1 0 0 0 Common Stock, no par value 1988-08-08 1988-08-08 4 A 0 12500 250000 A 12500 D Non-qualified stock options - right to buy 3.76 1988-08-08 1988-08-08 4 A 0 11719 3.76 A 1999-05-26 2004-05-26 Common Stock 11719 11719 D Non-qualified stock options - right to buy 2.88 1988-08-08 1988-08-08 4 A 0 11719 2.88 A 2000-05-24 2005-05-24 Common Stock 11719 11719 D Non-qualified stock options - right to buy 5.0624 1988-08-08 1988-08-08 4 A 0 15625 5.0624 A 2001-05-23 2011-05-23 Common Stock 15625 15625 D Non-qualified stock options - right to buy 16.99 1988-08-08 1988-08-08 4 A 0 10000 16.99 A 2002-05-23 2012-05-23 Common Stock 10000 10000 D Non-qualified stock options - right to buy 18.62 2003-05-22 2003-05-22 4 A 0 15000 18.62 A 2003-05-22 2013-05-22 Common Stock 15000 15000 D Michael E. Stillabower by Kent W. Stanger, per Pwr of Atty dtd 04/03/96, on file w/SEC and incorporatred by reference 2003-07-02 -----END PRIVACY-ENHANCED MESSAGE-----