-----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, WvOKAdoW/dpYj2U1TlVQ+OzUQr4nqZTYxK1KXxQeQMHFw6iep4ICMy0AFMY4XqEK ygoyxQrvDkAlW21Z2MoyHQ== 0000931731-03-000312.txt : 20030908 0000931731-03-000312.hdr.sgml : 20030908 20030908113240 ACCESSION NUMBER: 0000931731-03-000312 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20030904 FILED AS OF DATE: 20030908 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BEAN REX C CENTRAL INDEX KEY: 0001184930 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-18592 FILM NUMBER: 03885343 BUSINESS ADDRESS: STREET 1: 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 1 form4-rcbean090403_ex.xml X0201 4 2003-09-04 0 0000856982 MERIT MEDICAL SYSTEMS INC MMSI 0001184930 BEAN REX C 1600 W. MERIT PARKWAY SOUTH JORDAN UT 84095 1 0 0 0 Common Stock, no par value 1988-08-08 1988-08-08 4 S 0 100 21.90 D 193879 D Common Stock, no par value 1988-08-08 1988-08-08 4 A 0 52584 A 52584 D Common Stock, no par value 1988-08-08 1988-08-08 4 A 0 13333 A 13333 D Common Stock, no par value 1988-08-08 1988-08-08 4 A 0 12600 A 12600 D Nonqualified stock option (right to buy) 2.82 1988-08-08 1988-08-08 4 A 0 15625 2.82 A 1999-05-26 2004-05-26 Common Stock 15625 15625 D Nonqualified stock option (right to buy) 2.16 1988-08-08 1988-08-08 4 A 0 15625 2.16 A 2000-05-26 2005-05-24 Common Stock 15625 15625 D Nonqualified stock option (right to buy) 3.79 1988-08-08 1988-08-08 4 A 0 20833 3.79 A 2001-05-23 2011-05-23 Common Stock 20833 20833 D Nonqualified stock option (right to buy) 12.74 1988-08-08 1988-08-08 4 A 0 13333 12.74 A 2002-05-23 2012-05-23 Common Stock 13333 13333 D Nonqualified stock option (right to buy) 13.96 1988-08-08 1988-08-08 4 A 0 20000 13.96 A 2003-05-22 2012-05-22 Common Stock 20000 20000 D End of month number reflects split (4 for 3) forward split effective 8/15/03. Ownership by Bean Family Investment LLC Ownership by Rex Bean Trust (revocable) Ownership by Rex & Anita Bean Trust Ownership by Rex Bean Cert Rex C. Bean by Greg Barnett as Atty-in-Fact per Pwr of Atty dtd 9/14/2002, on file with the Commission and incorporated herein 2003-09-05 -----END PRIVACY-ENHANCED MESSAGE-----