-----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, OOTel1q2wff51w7s1338EemALjZp01KwUIZuen4tTqx9S0Vv8uaRaTkOJkqlzFNE T4dDvmuR3xwNQ+zCMGRB3g== 0001179110-06-003346.txt : 20060210 0001179110-06-003346.hdr.sgml : 20060210 20060210164723 ACCESSION NUMBER: 0001179110-06-003346 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20051231 FILED AS OF DATE: 20060210 DATE AS OF CHANGE: 20060210 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Stephens Martin R CENTRAL INDEX KEY: 0001310727 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-18592 FILM NUMBER: 06599293 BUSINESS ADDRESS: BUSINESS PHONE: 801 208-4141 MAIL 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 5 1 edgar.xml FORM 5 - X0202 5 2005-12-31 0 0 0 0000856982 MERIT MEDICAL SYSTEMS INC MMSI 0001310727 Stephens Martin R 1600 W. MERIT PARKWAY SOUTH JORDAN UT 84095 0 1 0 0 VP of Sales Common Stock, No Par Value 7400 D Common Stock, No Par Value 1909 D Common Stock, No Par Value 1961 I By 401 (k) Plan Employee Stock Purchase Plan as of 12-31-2005. Represents shares held by the Merit Medical Systems, Inc. 401 (k) Profit Sharing Plan and Trust for the Benefit of the reporting person as of 12-31-2005. Martin R. Stephens 2006-02-10 -----END PRIVACY-ENHANCED MESSAGE-----