-----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, U6rFK8ydId5BMWzZOO8J1bWh1XHeC/HSo8Q5gICx+t/nVtR6JzwZLzpln+AoLWf2 yjHG36xfa0dPfpcp+MTg5g== 0000931731-04-000005.txt : 20040121 0000931731-04-000005.hdr.sgml : 20040121 20040121213324 ACCESSION NUMBER: 0000931731-04-000005 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040120 FILED AS OF DATE: 20040121 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: LAMPROPOULOS FRED P CENTRAL INDEX KEY: 0000901534 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-18592 FILM NUMBER: 04536440 BUSINESS ADDRESS: STREET 1: 1600 W MARIT PARKWAY CITY: SO JORDAN STATE: UT ZIP: 84095 BUSINESS PHONE: 84095-1688 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-fpl012004_ex.xml X0201 4 2004-01-20 0 0000856982 MERIT MEDICAL SYSTEMS INC MMSI 0000901534 LAMPROPOULOS FRED P 1600 W MARIT PARKWAY SO JORDAN UT 84095 1 1 1 0 President, CEO Common Stock, no par value 2004-01-20 2004-01-20 4 G 0 1060 D 845184 D Common Stock, no par value 2004-01-20 2004-01-20 4 G 0 1060 D 844124 D Common Stock, no par value 2004-01-20 2004-01-20 4 G 0 1060 D 843064 D Common Stock, no par value 1988-08-08 1988-08-08 4 G 0 54873 A 54873 I by 401(k) Plan Represents plan holdings as of 01/21/04 per most recent plan statement timely distributed. Gift Fred P. Lampropoulos 2004-01-21 -----END PRIVACY-ENHANCED MESSAGE-----