-----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, NKrHXyMqYSzM0a9583PqGsGb9Jr8eTQokfCz5josXk9+Fg7JUtkHHYn9D4gpjpAB klM2klkUIVDTrO74YIBLYA== 0000931731-03-000374.txt : 20031029 0000931731-03-000374.hdr.sgml : 20031029 20031029124536 ACCESSION NUMBER: 0000931731-03-000374 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20031028 FILED AS OF DATE: 20031029 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: STANGER KENT W CENTRAL INDEX KEY: 0000901531 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-18592 FILM NUMBER: 03962851 BUSINESS ADDRESS: STREET 1: 79 WEST 4500 SOUTH STREET 2: SUITE 9 CITY: SALT LAKE CITY STATE: UT ZIP: 84107 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-kws102803_ex.xml X0201 4 2003-10-28 0 0000856982 MERIT MEDICAL SYSTEMS INC MMSI 0000901531 STANGER KENT W 79 WEST 4500 SOUTH SUITE 9 SALT LAKE CITY UT 84107 1 1 0 0 Chief Financial Officer Common Stock, no par value 2003-10-27 2003-10-27 4 M 0 5000 2.76 A 5000 D Common Stock, no par value 2003-10-27 2003-10-27 4 S 0 5000 25.25 D 0 D Common Stock, no par value 2003-10-27 2003-10-27 4 M 0 5000 2.76 D 305564 D Common Stock, no par value 2003-10-27 2003-10-27 4 S 0 5000 25.00 D 300564 D Common Stock, no par value 1988-08-08 1988-08-08 4 A 0 111031 A 111031 I Family limited partnership Common Stock, no par value 1988-08-08 1988-08-08 4 A 0 35989 A 35989 I 401(K) Plan Common Stock, no par value 1988-08-08 1988-08-08 4 A 0 2562 A 2562 I Employee Stock Purchase Plan Nonqualified Stock Options (right to buy) 2.76 2003-10-27 4 M 0 10000 2.76 D 1999-09-30 2004-03-31 Common Stock 10000 10833 D Nonqualified Stock Options (right to buy) 2.82 1988-08-08 1988-08-08 4 M 0 15625 2.82 D 1999-05-26 2004-05-26 Common Stock 15625 15625 D Nonqualified Stock Options (right to buy) 3.15 1988-08-08 1988-08-08 4 M 0 18231 3.15 D 2000-04-23 2004-10-23 Common Stock 18231 18231 D Nonqualified Stock Options (right to buy) 2.16 1988-08-08 1988-08-08 4 M 0 15625 2.16 D 2000-05-24 2005-05-24 Common Stock 15625 15625 D Nonqualified Stock Options (right to buy) 2.16 1988-08-08 1988-08-08 4 M 0 41667 2.16 D 2001-01-24 2005-05-24 Common Stock 41667 41667 D Nonqualified Stock Options (right to buy) 2.76 1988-08-08 1988-08-08 4 M 0 41667 2.76 D 2002-02-12 2011-02-12 Common Stock 41667 41667 D Nonqualified Stock Options (right to buy) 3.80 1988-08-08 1988-08-08 4 M 0 20833 3.80 D 2001-05-23 2011-05-23 Common Stock 20833 20833 D Nonqualified Stock Options (right to buy) 10.15 1988-08-08 1988-08-08 4 M 0 33333 10.15 D 2002-12-08 2011-12-08 Common Stock 33333 33333 D Nonqualified Stock Options (right to buy) 12.74 1988-08-08 1988-08-08 4 M 0 13333 12.74 D 2002-05-23 2012-05-23 Common Stock 13333 13333 D Nonqualified Stock Options (right to buy) 12.99 1988-08-08 1988-08-08 4 M 0 26667 12.99 D 2004-02-06 2013-02-06 Common Stock 26667 26667 D Nonqualified Stock Options (right to buy) 13.97 1988-08-08 1988-08-08 4 M 0 20000 13.97 D 2003-05-22 2013-05-22 Common Stock 20000 20000 D Represent plan holdings as of 10/28/03 End of month numbers reflect stock split (4 for 3) forward split effective 8/15/03 Become exercisable in equal annual installments of 20% commencing 12/08/02 Become exercisable in equal annual installments of 20% commencing 09/30/99 Become exercisable in equal annual installments of 20% commencing 04/23/00 Become exercisable in equal annual installments of 20% commencing 02/12/02 Become exercisable in equal annual installments of 20% commencing 02/06/04 Kent W. Stanger 2003-10-29 -----END PRIVACY-ENHANCED MESSAGE-----