0001179110-12-002395.txt : 20120213
0001179110-12-002395.hdr.sgml : 20120213
20120213174507
ACCESSION NUMBER: 0001179110-12-002395
CONFORMED SUBMISSION TYPE: 5
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20111231
FILED AS OF DATE: 20120213
DATE AS OF CHANGE: 20120213
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: STANGER KENT W
CENTRAL INDEX KEY: 0000901531
FILING VALUES:
FORM TYPE: 5
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-18592
FILM NUMBER: 12600745
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 -
X0304
5
2011-12-31
0
0
0
0000856982
MERIT MEDICAL SYSTEMS INC
MMSI
0000901531
STANGER KENT W
1600 W MERIT PARKWAY
SOUTH JORDAN
UT
84095
1
1
0
0
Chief Financial Officer
Common Stock, No Par Value
73709
I
By 401(k) plan
Common Stock, No Par Value
185051
I
Family Limited Partnership
Common Stock, No Par Value
4270
D
Common Stock, No Par Value
2011-12-20
5
G
0
2731
0
D
582089
D
Non-qualified stock options (right to buy)
7.65
2002-05-23
2012-05-23
Common Stock
22221
22221
D
Non-qualified stock options (right to buy)
7.79
2004-02-06
2013-02-06
Common Stock
44445
44445
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)
17.34
2004-12-13
2013-12-13
Common Stock
17500
17500
D
Non-qualified stock options (right to buy)
11.05
2004-06-10
2014-06-10
Common Stock
7500
7500
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)
12.02
2004-12-18
2014-12-18
Common Stock
25000
25000
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)
9.71
2005-12-28
2015-12-28
Common Stock
25000
25000
D
Non-qualified stock options (right to buy)
9.22
2007-05-25
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
25000
25000
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
43750
43750
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)
13.75
2012-08-11
2018-08-11
Common Stock
80000
80000
D
Represents plan holdings as of 12/31/11.
Employee stock purchase plan as of 12/31/11.
Becomes exercisable in equal annual installments of 20% commmencing 02/06/2004.
Becomes exercisable in equal annual installments of 33.33% commmencing 05/25/2007.
Becomes exercisable in equal annual installments of 20% commmencing 06/27/2008.
Becomes exercisable in equal annual installments of 20% commmencing 05/21/2009.
Becomes exercisable in equal annual installments of 20% commmencing 09/26/2010.
Becomes exercisable in equal annual installments of 20% commmencing 08/11/2012.
Reflects two gifts to two unaffiliated parties.
Kent W. Stanger
2012-02-13