-----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, GiterR6p+1hesnR55OiVtxZdv3Pf9MkoFX1py1T34Y6TA1ggr4kNjfSHT9CnReUV 0J+82NzF1Cd1Hw5Z2ufe+g== 0001179110-05-014194.txt : 20050713 0001179110-05-014194.hdr.sgml : 20050713 20050713165929 ACCESSION NUMBER: 0001179110-05-014194 CONFORMED SUBMISSION TYPE: 4/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040513 FILED AS OF DATE: 20050713 DATE AS OF CHANGE: 20050713 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 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BEAN REX C CENTRAL INDEX KEY: 0001184930 FILING VALUES: FORM TYPE: 4/A SEC ACT: 1934 Act SEC FILE NUMBER: 000-18592 FILM NUMBER: 05952812 BUSINESS ADDRESS: STREET 1: 1600 W. MERIT PARKWAY CITY: SOUTH JORDAN STATE: UT ZIP: 84095 4/A 1 edgar.xml FORM 4/A - X0202 4/A 2004-05-13 2004-05-14 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 2004-05-13 4 M 0 20833 2.12 A 191005 I Bean Family Investment LLC Common Stock 2004-05-13 4 F 0 2806 15.70 D 188199 I Bean Family Investment LLC Common Stock, No Par Value 16800 I Rex Bean Trust (revocable) Common Stock, No Par Value 70112 I Rex & Antia Bean Trust Common Stock, No Par Value 17777 D Non-qualified stock options (right to buy) 2.12 2004-05-13 4 M 0 20883 2.12 D 1999-05-26 2004-05-26 Common Stock 20883 0 D non-qualified stock options (right to buy) 1.62 2000-05-24 2005-05-24 Common Stock 20833 20833 D non-qualified stock options (right to buy) 2.85 2001-05-23 2011-05-23 Common Stock 27777 27777 D non-qualified stock options (right to buy) 9.56 2002-05-23 2012-05-23 Common Stock 17777 17777 D non-qualified stock options (right to buy) 10.47 2003-05-22 2013-05-22 Common Stock 26667 26667 D non-qualified stock options (right to buy) 21.67 2003-12-13 2013-12-13 Common Stock 15000 15000 D This amendment is due to addition error and ownership error Rex Bean (Cert) This amendment is due to incorrect date entry Rex C Bean 2004-05-14 -----END PRIVACY-ENHANCED MESSAGE-----