-----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, Cq03FCAMXNz3sX0BNp9HckJvga0WdRv5j6g1rxc/0UKoXInNWjMd18W2ozSuuYRw E8CDQGKzaMXjtNL9fvFA/g== 0000931731-03-000431.txt : 20031125 0000931731-03-000431.hdr.sgml : 20031125 20031125103423 ACCESSION NUMBER: 0000931731-03-000431 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20031124 FILED AS OF DATE: 20031125 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: PERRY RASHELLE CENTRAL INDEX KEY: 0001184963 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-18592 FILM NUMBER: 031022163 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 1 form4-rperry112403_ex.xml X0201 4 2003-11-24 0 0000856982 MERIT MEDICAL SYSTEMS INC MMSI 0001184963 PERRY RASHELLE MERIT MEDICAL SYSTEMS INC 1600 W. MERIT PARKWAY SOUTH JORDAN UT 84095 0 1 0 0 Chief Legal Officer Common Stock, no par value 2003-11-21 2003-11-21 4 M 0 8332 5.41 A 8332 D Common Stock, no par value 2003-11-21 2003-11-21 4 S 0 8332 28.42 D 0 D Common Stock, no par value 2003-11-21 2003-11-21 4 M 0 3333 10.15 A 3333 D Common Stock, no par value 2003-11-21 2003-11-21 4 S 0 3333 28.42 D 0 D Common Stock, no par value 1988-08-08 1988-08-08 4 M 0 463 A 463 I by 401(k) Plan Non-qualified stock options (right to buy) 5.41 2003-11-21 2003-11-21 4 M 0 8332 5.41 D 2002-08-06 2011-08-06 Common Stock 8332 12501 D Non-qualified stock options (right to buy) 10.15 2003-11-21 2003-11-21 4 M 0 3333 10.15 D 2002-12-08 2011-12-08 Common Stock 3333 3333 D Non-qualified stock options (right to buy) 12.99 1988-08-08 1988-08-08 4 M 0 13333 10.15 D 2004-02-06 2013-02-06 Common Stock 13333 13333 D Become exercisable in equal annual installments of 20% commencing 08/06/02 Become exercisable in equal annual installments of 20% commencing 12/08/02 Become exercisable in equal annual installments of 20% commencing 02/06/04 Represent plan holding as of 11/24/03 End of month reflects stock split (4 for 3) forward split August 11, 2003. Rashelle Perry 2003-11-24 -----END PRIVACY-ENHANCED MESSAGE-----