-----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, FPUgjVSAXZPcVJVttch4rmfaXF+VJunXfQUuwPzGamy7NRTfzbHYmlSmtBvv3eCV g/8xOcfcG48WjrJsKqA0Ww== 0000931731-04-000041.txt : 20040226 0000931731-04-000041.hdr.sgml : 20040226 20040226182215 ACCESSION NUMBER: 0000931731-04-000041 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040226 FILED AS OF DATE: 20040226 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: 04632042 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-rcbean022604_ex.xml X0201 4 2004-02-26 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 2004-02-25 2004-02-25 4 S 0 2000 20.00 D 243172 D Common Stock, no par value 2004-02-26 2004-02-26 4 S 0 2000 20.10 D 241172 D Common Stock, no par value 2004-02-26 2004-02-26 4 S 0 4000 20.20 D 239172 D Common Stock, no par value 2004-02-26 2004-02-26 4 S 0 2000 20.30 D 235172 D Common Stock, no par value 2004-02-26 2004-02-26 4 S 0 2000 20.40 D 233172 D Common Stock, no par value 1988-08-08 1988-08-08 4 M 0 16800 A 16800 D Common Stock, no par value 1988-08-08 1988-08-08 4 M 0 70112 A 70112 D Common Stock, no par value 1988-08-08 1988-08-08 4 M 0 17777 A 17777 D Nonqualified Stock Option (right to buy) 2.12 1988-08-08 1988-08-08 4 M 0 20833 2.12 A 1999-05-26 2004-05-26 Common Stock 20833 20833 D Nonqualified Stock Option (right to buy) 1.62 1988-08-08 1988-08-08 4 M 0 20833 1.62 A 2000-05-24 2005-05-24 Common Stock 20833 20833 D Nonqualified Stock Option (right to buy) 2.85 1988-08-08 1988-08-08 4 M 0 27777 2.85 A 2001-05-23 2011-05-23 Common Stock 27777 27777 D Nonqualified Stock Option (right to buy) 9.56 1988-08-08 1988-08-08 4 M 0 17777 9.56 A 2002-05-23 2012-05-23 Common Stock 17777 17777 D Nonqualified Stock Option (right to buy) 10.47 1988-08-08 1988-08-08 4 M 0 26667 10.47 A 2003-05-22 2013-05-22 Common Stock 26667 26667 D Nonqualified Stock Option (right to buy) 21.67 1988-08-08 1988-08-08 4 M 0 15000 21.67 A 2003-12-13 2013-12-13 Common Stock 15000 15000 D Bean Family Investment LLC Rex Bean Trust (revocable) Rex & Anita Bean Trust Rex Bean Cert Rex C. Bean by Greg Barnett as Atty-in-Fact, per Pwr of Atty dtd 9/14/02, a manually signed copy of which is on file with the SEC and is incorporated herein by reference 2004-02-26 -----END PRIVACY-ENHANCED MESSAGE-----