0001179110-12-007749.txt : 20120504 0001179110-12-007749.hdr.sgml : 20120504 20120504140543 ACCESSION NUMBER: 0001179110-12-007749 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20120502 FILED AS OF DATE: 20120504 DATE AS OF CHANGE: 20120504 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: LAMPROPOULOS FRED P CENTRAL INDEX KEY: 0000901534 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-18592 FILM NUMBER: 12813477 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 - X0305 4 2012-05-02 0 0000856982 MERIT MEDICAL SYSTEMS INC MMSI 0000901534 LAMPROPOULOS FRED P 1600 W MERIT PARKWAY SOUTH JORDAN UT 84095 1 1 0 0 President & CEO Common Stock, No Par Value 84792 I By 401(k) Plan Common Stock, No Par Value 2012-05-02 4 M 0 22221 7.65 A 1030459 D Common Stock, No Par Value 2012-05-02 4 F 0 15717 13.35 D 1014742 D Non-qualified stock options (right to buy) 7.65 2012-05-02 4 M 0 22221 0 D 2002-05-23 2012-05-23 Common Stock 22221 0 D Non-qualified stock options (right to buy) 7.79 2004-02-06 2013-02-06 Common Stock 88889 88889 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 2004-12-13 2013-12-13 Common Stock 35000 35000 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) 11.05 2004-06-10 2014-06-10 Common Stock 15000 15000 D Non-qualified stock options (right to buy) 12.02 2004-12-18 2014-12-18 Common Stock 50000 50000 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) 14.39 2005-07-15 2015-07-15 Common Stock 93750 93750 D Non-qualified stock options (right to buy) 9.71 2005-12-28 2015-12-28 Common Stock 50000 50000 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 50000 50000 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 68750 68750 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 120000 120000 D Represents plan holdings as of 5/2/2012. Becomes exercisable in equal annual installments of 20% commencing 2/6/2004. Becomes exercisable in equal annual installments of 20% commencing 12/13/2004. Becomes exercisable in equal annual installments of 33.33% commencing 5/25/2007. Becomes exercisable in equal annual installments of 20% commencing 6/27/2008. Becomes exercisable in equal annual installments of 20% commencing 5/21/2009. Becomes exercisable in equal annual installments of 20% commencing 9/26/2010. Becomes exercisable in equal annual installments of 20% commencing 8/11/2012. Stock options were exercised in a swap transaction with the Company. 15,717 shares of common stock were surrendered for payroll taxes and payment of the option price. No shares were sold in the open market. Gregory L. Barnett, Attorney-in-Fact 2012-05-04