-----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, TZLPrLNHAuEVi/AjhxWua8pUkOeatEFzJRmqrbHc7ZLA7+CspRYEIik9fxRwqzR7 Md4UDes6ZL/NIJ445R0cUA== 0000931731-04-000025.txt : 20040205 0000931731-04-000025.hdr.sgml : 20040205 20040205122520 ACCESSION NUMBER: 0000931731-04-000025 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040204 FILED AS OF DATE: 20040205 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: WEINTRAUB B LEIGH CENTRAL INDEX KEY: 0001184965 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-18592 FILM NUMBER: 04569215 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-blw020404_ex.xml X0201 4 2004-02-04 0 0000856982 MERIT MEDICAL SYSTEMS INC MMSI 0001184965 WEINTRAUB B LEIGH MERIT MEDICAL SYSTEMS INC 1600 W. MERIT PARKWAY SOUTH JORDAN UT 84095 0 1 0 0 Vice President - Operations Common Stock, no par value 1988-08-08 1988-08-08 4 M 0 1392 A 1392 D Common Stock, no par value 1988-08-08 1988-08-08 4 M 0 1019 A 1019 D Common Stock, no par value 1988-08-08 1988-08-08 4 M 0 6849 A 6849 I by 401(k) Plan Non-qualified Stock Option (right to buy) 7.61 1988-08-08 1988-08-08 4 M 0 35556 7.61 A 2002-12-08 2011-12-08 Common Stock 35556 35556 D Non-qualified Stock Option (right to buy) 2.07 1988-08-08 1988-08-08 4 M 0 33335 2.07 A 2002-02-12 2011-02-12 Common Stock 33335 33335 D Non-qualified Stock Option (right to buy) 2.36 1988-08-08 1988-08-08 4 M 0 4863 2.36 A 2000-04-23 2004-10-23 Common Stock 4863 4863 D Non-qualified Stock Option (right to buy) 9.74 1988-08-08 1988-08-08 4 M 0 35556 9.74 A 2004-02-06 2013-02-06 Common Stock 35556 35556 D Non-qualified Stock Option (right to buy) 21.67 2003-12-13 2003-12-13 4 A 0 14000 21.67 A 2004-12-13 2013-12-03 Common Stock 14000 14000 D Represent plan holdings as of 02/03/04 per most recent plan statement timely distributed Numbers reflect (4 for 3) forward split effective 12/03/03. Become exercisable in equal annual installments of 20% commencing 12/08/02 Become exercisable in equal annual installments of 20% commencing 12/13/04 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 Employee stock purchase per 401(k) Plan B. Leigh Weintraub 2004-02-05 -----END PRIVACY-ENHANCED MESSAGE-----