0001179110-11-016667.txt : 20111215 0001179110-11-016667.hdr.sgml : 20111215 20111215151141 ACCESSION NUMBER: 0001179110-11-016667 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20111213 FILED AS OF DATE: 20111215 DATE AS OF CHANGE: 20111215 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: STILLABOWER MICHAEL E CENTRAL INDEX KEY: 0001192955 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-18592 FILM NUMBER: 111263282 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 2011-12-13 0 0000856982 MERIT MEDICAL SYSTEMS INC MMSI 0001192955 STILLABOWER MICHAEL E 1600 W. MERIT PARKWAY SOUTH JORDAN UT 84095 1 0 0 0 Common Stock, No Par Value 2011-12-13 4 M 0 1082 7.65 A 28860 D Common Stock, No Par Value 2011-12-13 4 S 0 1082 13.65 D 27778 D Non-qualified stock options (right to buy) 7.65 2011-12-13 4 M 0 1082 0 D 2002-05-23 2012-05-23 Common Stock 1082 1926 D Non-qualified stock options (right to buy) 8.38 2003-05-22 2013-05-22 Common Stock 33334 33334 D Non-qualified stock options (right to buy) 17.34 2003-12-13 2013-12-13 Common Stock 18750 18750 D Non-qualified stock options (right to buy) 11.05 2004-06-10 2014-06-10 Common Stock 18750 18750 D Non-qualified stock options (right to buy) 11.41 2005-05-25 2015-05-25 Common Stock 18750 18750 D Non-qualified stock options (right to buy) 9.22 2006-05-25 2013-05-25 Common Stock 18750 18750 D Non-qualified stock options (right to buy) 9.70 2008-06-27 2014-06-27 Common Stock 18750 18750 D Non-qualified stock options (right to buy) 11.53 2009-05-21 2015-05-21 Common Stock 18750 18750 D Non-qualified stock options (right to buy) 13.82 2010-09-26 2016-09-26 Common Stock 25000 25000 D Non-qualified stock options (right to buy) 13.16 2011-06-25 2017-06-25 Common Stock 25000 25000 D Non-qualified stock options (right to buy) 13.75 2012-08-11 2018-08-11 Common Stock 20000 20000 D Become exercisable in equal annual installments of 20% commencing 06/27/2008. Become exercisable in equal annual installments of 20% commencing 05/21/2009. Become exercisable in equal annual installments of 20% commencing 09/26/2010. Become exercisable in equal annual installments of 20% commencing 06/25/2011. Become exercisable in equal annual installments of 20% commencing 08/11/2012. These shares were sold in multiple transactions for the same share price of $13.65. 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 footnote. Greg Barnett, Attorney-in-Fact 2011-12-15