-----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, G4VwLUbCFHB1I7OWRgzFHWIn6Khmu1qbiagyDhtUv0AiJJrhIBb2/Jpw33cpylck 0KItUjUY4pBpo0rNB2M12A== 0000931731-04-000056.txt : 20040312 0000931731-04-000056.hdr.sgml : 20040312 20040312111112 ACCESSION NUMBER: 0000931731-04-000056 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040310 FILED AS OF DATE: 20040312 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: 04664553 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-fpl031004_ex.xml X0201 4 2004-03-10 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 2003-03-10 2003-03-10 4 M 1 30556 2.07 A 868620 D Common Stock, no par value 2003-03-10 2003-03-10 4 F 1 10245 21.50 D 858375 D Common Stock, no par value 1988-08-08 1988-08-08 4 F 1 54873 D 54873 I by 401(k) Plan Nonqualified Stock Options (right to buy) 2.07 2004-03-10 2004-03-10 4 M 1 30556 2.07 D 1999-09-30 2004-03-31 Common Stock 30556 25000 D Nonqualified Stock Options (right to buy) 2.12 1988-08-08 1988-08-08 4 M 1 20833 2.12 D 1999-05-26 2004-05-26 Common Stock 20833 20833 D Nonqualified Stock Options (right to buy) 1.62 1988-08-08 1988-08-08 4 M 1 20833 1.62 D 2000-05-24 2005-05-24 Common Stock 20833 20833 D Nonqualified Stock Options (right to buy) 1.62 1988-08-08 1988-08-08 4 M 1 11111 1.62 D 2001-01-24 2005-05-24 Common Stock 11111 11111 D Nonqualified Stock Options (right to buy) 2.07 1988-08-08 1988-08-08 4 M 1 11111 2.07 D 2002-02-12 2011-02-12 Common Stock 11111 11111 D Nonqualified Stock Options (right to buy) 2.85 1988-08-08 1988-08-08 4 M 1 27777 2.85 D 2001-05-23 2011-05-23 Common Stock 27777 27777 D Nonqualified Stock Options (right to buy) 7.61 1988-08-08 1988-08-08 4 M 1 88889 7.61 D 2002-12-08 2011-12-08 Common Stock 88889 88889 D Nonqualified Stock Options (right to buy) 9.56 1988-08-08 1988-08-08 4 M 1 17777 9.56 D 2002-05-23 2012-05-23 Common Stock 17777 17777 D Nonqualified Stock Options (right to buy) 9.74 1988-08-08 1988-08-08 4 M 1 71111 9.74 D 2002-02-06 2013-02-06 Common Stock 71111 71111 D Nonqualified Stock Options (right to buy) 10.47 1988-08-08 1988-08-08 4 M 1 26667 10.47 D 2003-05-22 2013-05-22 Common Stock 26667 26667 D Nonqualified Stock Options (right to buy) 21.67 1988-08-08 1988-08-08 4 M 1 28000 21.67 D 2004-12-13 2013-12-13 Common Stock 28000 28000 D Nonqualified Stock Options (right to buy) 21.67 1988-08-08 1988-08-08 4 M 1 15000 21.67 D 2003-12-13 2013-12-13 Common Stock 15000 15000 D Represent plan holdings as of 02/03/04 per most recent plan statement timely distributed. Become exercisable in equal annual installments of 20% commencing 02/12/02 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 09/30/99 Become exercisable in equal annual installments of 20% commencing 02/06/04 Fred P. Lampropoulos 2004-03-10 -----END PRIVACY-ENHANCED MESSAGE-----