0001179110-11-012232.txt : 20110815 0001179110-11-012232.hdr.sgml : 20110815 20110815173701 ACCESSION NUMBER: 0001179110-11-012232 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20110811 FILED AS OF DATE: 20110815 DATE AS OF CHANGE: 20110815 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: 111038107 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 - X0304 4 2011-08-11 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 9435 D Common Stock, No Par Value 643 D Common Stock, No Par Value 287 I By 401(k)plan 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 Non-qualified stock options (right to buy) 13.75 2011-08-11 4 A 0 40000 0 A 2012-08-11 2018-08-11 Common Stock 40000 40000 D Acquired under the Employee Stock Purchase Plan. 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. Represents plan holdings as of 08/11/11. Become exercisable in equal annual installments of 20% commencing 08/11/12. Gregory L. Barnett, Attorney-in-Fact 2011-08-15