0001179110-11-008239.txt : 20110518 0001179110-11-008239.hdr.sgml : 20110518 20110518183012 ACCESSION NUMBER: 0001179110-11-008239 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20110513 FILED AS OF DATE: 20110518 DATE AS OF CHANGE: 20110518 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: PERRY RASHELLE CENTRAL INDEX KEY: 0001184963 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-18592 FILM NUMBER: 11855991 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 edgar.xml FORM 4 - X0303 4 2011-05-13 0 0000856982 MERIT MEDICAL SYSTEMS INC MMSI 0001184963 PERRY RASHELLE 1600 W. MERIT PARKWAY SOUTH JORDAN UT 84095 0 1 0 0 Chief Legal Officer Common Stock, No Par Value 2011-05-13 4 S 0 8546 19.00 D 2508 I By 401 (k) plan Common Stock, No Par Value 2011-05-16 4 S 0 2508 19.01 D 0 I By 401 (k) plan. Common Stock, No Par Value 1958 D Common Stock, No Par Value 643 D Non-qualified stock options (right to buy) 7.79 2004-02-06 2013-02-06 Common Stock 22221 22221 D Non-qualified stock options (right to buy) 17.34 2004-12-13 2013-12-13 Common Stock 8750 8750 D Non-qualified stock options (right to buy) 11.05 2004-06-10 2014-06-10 Common Stock 3750 3750 D Non-qualified stock options (right to buy) 12.02 2004-12-18 2014-12-18 Common Stock 12500 12500 D Non-qualified stock options (right to buy) 9.71 2005-12-28 2015-12-28 Common Stock 12500 12500 D Non-qualified stock options (right to buy) 9.70 2008-06-27 2014-06-27 Common Stock 12500 12500 D Non-qualified stock options (right to buy) 11.53 2009-05-21 2015-05-21 Common Stock 25000 25000 D Acquired under the Employee Stock Purchase Plan of 12/31/05. Become exercisable in equal annual installments of 20% commencing 02/06/04. Become exercisable in equal annual installments of 20% commencing 12/13/04. Become exercisable in equal annual installments of 20% commencing 06/27/08. Become exercisable in equal annual installments of 20% commencing 05/21/09. The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $19.0100 to $19.0101, inclusive. The reporting person undertakes to provide to Merit Medical Systems, Inc., any security holder of Merit Medical Systems, Inc., or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth in this Form 4. Amounts have been adjusted to reflect the 5-for-4 split of the issuer's common stock that was effected on May 5, 20ll. The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $18.99 to $19.00, inclusive. The reporting person undertakes to provide to Merit Medical Systems, Inc., any security holder of Merit Medical Systems, Inc., or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth in this Form 4. Represents plan holdings as of May 13, 2011. Gregory L. Barnett, Attorney-in-Fact 2011-05-18