-----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, GWdwYRWMMpNuqzzFyQFr+KZ5J99qzpmZgoMez4mvJwVUHIwm+z/gYPor1HIFS6Zx km7Z61TdZm1dOSqelUIuPQ== 0000931731-97-000043.txt : 19970222 0000931731-97-000043.hdr.sgml : 19970222 ACCESSION NUMBER: 0000931731-97-000043 CONFORMED SUBMISSION TYPE: SC 13G PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 19970220 SROS: NASD SUBJECT COMPANY: 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 FILING VALUES: FORM TYPE: SC 13G SEC ACT: 1934 Act SEC FILE NUMBER: 005-45861 FILM NUMBER: 97539035 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 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: LAMPROPOULOS FRED P CENTRAL INDEX KEY: 0000901534 STANDARD INDUSTRIAL CLASSIFICATION: [] IRS NUMBER: 870447694 FILING VALUES: FORM TYPE: SC 13G BUSINESS ADDRESS: STREET 1: 1600 W MARIT PARKWAY CITY: SO JORDAN STATE: UT ZIP: 84095 BUSINESS PHONE: 84095-1688 SC 13G 1 February 19, 1997 VIA ELECTRONIC TRANSMISSION Securities and Exchange Commission 450 Fifth Street, N.W. Washington, D.C. 20549 Re: Amendment to Schedule 13G Ladies and Gentlemen: Submitted herewith is Amendment No. 6 to the Schedule 13G for Fred P. Lampropoulos. This filing is being effected by direct transmission via the Commission's EDGAR System. No fee is required in connection with this filing. If you have any questions concerning this material, please do not hesitate to call the undersigned or Richard G. Brown at (801) 532-7840. Sincerely, /s/ SUSAN ALLEN Susan Allen Legal Assistant Attachment cc: Merit Medical Systems, Inc. richard G. Brown c:\wp51\secfil\sos\sec-ltr7.ska 1 OMB APPROVAL OMB Number 3235-0145 Expires: December 31, 1997 Estimated average burden hours per response.......14.90 UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 SCHEDULE 13G Under the Securities Exchange Act of 1934 (Amendment No. 6 )* Merit Medical Systems, Inc. - -------------------------------------------------------------------------------- (Name of Issuer) Common Stock, No Par Value - -------------------------------------------------------------------------------- (Title of Class of Securities) 589889-10-4 ------------------------------------------- (CUSIP Number) *The remainder of this cover page shall be filled out for a reporting person's initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter the disclosures provided in a prior cover page. The information required in the remainder of this cover page shall not be deemed to be "filed" for the purpose of Section 18 of the Securities Exchange Act of 1934 ("Act") or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes). SEC 1745 (2-95) Page 1 of 4 Pages CUSIP No. 589889-10-4 Page 2 of 4 Pages 13G - -------------------------------------------------------------------------------- 1 NAME OF REPORTING PERSON S.S. or I.R.S. IDENTIFICATION NO. OF ABOVE PERSON Fred P. Lampropoulos - -------------------------------------------------------------------------------- 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a) |_| (b) |_| - -------------------------------------------------------------------------------- 3 SEC USE ONLY - -------------------------------------------------------------------------------- 4 CITIZENSHIP OR PLACE OF ORGANIZATION United States - -------------------------------------------------------------------------------- 5 SOLE VOTING POWER NUMBER OF 630,618 SHARES ---------------------------------------------------- BENEFICIALLY 6 SHARED VOTING POWER OWNED BY EACH None REPORTING ---------------------------------------------------- PERSON 7 SOLE DISPOSITIVE POWER WITH 630,618 ---------------------------------------------------- 8 SHARED DISPOSITIVE POWER None - -------------------------------------------------------------------------------- 9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 630,618 - -------------------------------------------------------------------------------- 10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES* - -------------------------------------------------------------------------------- 11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 9.0% - -------------------------------------------------------------------------------- 12 TYPE OF REPORTING PERSON* IN - -------------------------------------------------------------------------------- *SEE INSTRUCTION BEFORE FILLING OUT! SEC 1745 (2-95) CUSIP NO. 589889-10-4 Page 3 of 4 Pages 13G Item 1. (a) Name of Issuer: Merit Medical Systems, Inc. (b) Address of Issuer's Principal Executive Offices: 1600 West Merit Parkway, South Jordan, Utah 84095 Item 2. (a) Name of Person Filing: Fred P. Lampropoulos (the "Reporting Person") (b) Address of Principal Business Office or, if none, Residence: 1600 West Merit Parkway, South Jordan, Utah 84095 (c) Citizenship: United States (d) Title of Class of Securities: Common Stock, no par value (the "Common Stock") (e) CUSIP Number: 589889-10-4 Item 3. This statement is not filed pursuant to Rule 13d-1(b) or 13d-2(b). Item 4. Ownership (a) Amount Beneficially Owned: As of December 31, 1996 the Reporting Person was the owner of 630,618 shares of the Common Stock, which includes 9,036 shares owned by the Reporting Person pursuant to the Issuer's 401(k) Plan, based upon the most recent plan statement timely distributed, and 51,500 shares that the Reporting Person has the right to acquire pursuant to presently exercisable options. (b) Percent of Class: 9.0% (c) Number of shares as to which the Reporting Person has: (i) sole power to vote or to direct the vote: 630,618 (ii) shared power to vote or to direct the vote: None (iii) sole power to dispose or to direct the disposition of: 630,618 (iv) shared power to dispose or to direct the disposition of: None SEC 1745 (2-95) CUSIP NO. 589889-10-4 Page 4 of 4 Pages 13G Item 5. Ownership of Five Percent or Less of a Class This statement is not being filed to report the fact that as of the date hereof the Reporting Person has ceased to be the beneficial owner of more than five percent of the class of securities. Item 6. Ownership of More than Five Percent on Behalf of Another Person Not applicable. Item 7. Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on By the Parent Holding Company Not applicable. Item 8. Identification and Classification of Members of the Group Not applicable. Item 9. Notice of Dissolution of Group Not applicable. Item 10. Certification Not applicable. SIGNATURE After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct. DATED: February 18, 1997 By /s/ FRED P. LAMPROPOULOS ------------------------ Fred P. Lampropoulos SEC 1745 (2-95) -----END PRIVACY-ENHANCED MESSAGE-----