-----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, UtWQTVb95S7kfequMb2XDC0kt1EZsa/Q9lX94X0QljnsXRLFXEmFkfnd2QHHpMlM LNn7v3wL7gPNG9PD+IVpsQ== 0000931731-03-000227.txt : 20030703 0000931731-03-000227.hdr.sgml : 20030703 20030703150048 ACCESSION NUMBER: 0000931731-03-000227 CONFORMED SUBMISSION TYPE: 4/A PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20030213 FILED AS OF DATE: 20030703 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: FERRAND BRIAN L CENTRAL INDEX KEY: 0001184964 FILING VALUES: FORM TYPE: 4/A SEC ACT: 1934 Act SEC FILE NUMBER: 000-18592 FILM NUMBER: 03775186 BUSINESS ADDRESS: STREET 1: MERIT MEDICAL SYSTEMS INC STREET 2: 1600 W. MERIT PARKWAY CITY: SOUTH JORDAN STATE: UT ZIP: 84095 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/A 1 form4a-bferrand021303_ex.xml X0101 4/A 2003-02-13 2003-02-18 0000856982 MERIT MEDICAL SYSTEMS INC MMSI 0001184964 FERRAND BRIAN L 0 1 0 0 Director of Sales Common Stock, no par value 1988-08-08 1988-08-08 4 J 0 4314 81103 A 4314 I By 401(k) Plan Represents plan holdings as of 12/31/2002 based upon most recent plan statements timely distributed Brian Ferrand by Kent Stanger, Atty-in-Fact, per Pwr of Atty dtd 8/10/92, on file with the SEC and incorporated by reference 2003-07-03 EX-99 3 ex99bferrand-4a021303.txt DERIVATIVES - FORM 4A BFERRAND 021303 EXHIBIT 99 - Derivative Securities - Brian Ferrand AMENDMENT TO REPORT FOR FEBRUARY 13, 2003 ----------------------------------------- FORM 4 (continued) ================================================================================ Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) ================================================================================

Explanation of Responses: (1) Represent plan holdings as of 12/31/02 based upon most recent plan statement timely distributed (2) Become exercisable in equal annual installments of 20% commencing 02/12/02 (3) Become exercisable in equal annual installments of 20% commencing 12/08/02 (4) Become exercisable in equal annual installments of 20% commencing 05/23/03 (5) Become exercisable in equal annual installments of 20% commencing 02/06/04 (6) This amendment is filed to correct the number of options reported as having been granted. (7) Become exercisable in equal annual installments of 20% commencing 09/30/99 /s/ KENT W. STANGER 07/03/03 - ------------------------------------------- ----------- Date **Signature of Reporting Person Kent W. Stanger as Attorney-in-Fact pursuant to a Power of Attorney dated August 10, 1992, a manually signed copy of which is on file with the Commission and is incorporated herein by reference. ** Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). Note: File three copies of this form, one of which must be manually signed. If space provided is insufficient, see Instruction 6 for procedure. -----END PRIVACY-ENHANCED MESSAGE-----