0001179110-12-013784.txt : 20120907
0001179110-12-013784.hdr.sgml : 20120907
20120907163041
ACCESSION NUMBER: 0001179110-12-013784
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20120906
FILED AS OF DATE: 20120907
DATE AS OF CHANGE: 20120907
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Nelson Arlin D
CENTRAL INDEX KEY: 0001382939
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-18592
FILM NUMBER: 121080380
MAIL ADDRESS:
STREET 1: 1600 W. MERIT PARKWAY
CITY: SOUTH JORDAN
STATE: UT
ZIP: 84095
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 -
X0306
4
2012-09-06
0
0000856982
MERIT MEDICAL SYSTEMS INC
MMSI
0001382939
Nelson Arlin D
1600 W. MERIT PARKWAY
SOUTH JORDAN
UT
84095
0
1
0
0
Chief Operating Officer
Common Stock, No Par Value
2012-09-06
4
M
0
11111
7.79
A
11411
D
Common Stock, No Par Value
2012-09-06
4
S
0
11111
14.61
D
300
D
Common Stock, No Par Value
928
I
By 401(k) Plan
Non-qualified Stock Options (right to buy)
7.79
2012-09-06
4
M
0
11111
0
D
2003-02-06
2013-02-06
Common Stock
11111
0
D
Non-qualified Stock Options (right to buy)
17.34
2003-12-13
2013-12-13
Common Stock
4375
4375
D
Non-qualified Stock Options (right to buy)
11.05
2004-06-10
2014-06-10
Common Stock
1875
1875
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
25000
25000
D
Non-qualified stock options (right to buy)
11.53
2009-05-21
2015-05-21
Common Stock
31250
31250
D
Non-qualified stock options (right to buy)
13.75
2012-08-11
2018-08-11
Common Stock
25000
25000
D
Represents plan holdings as of 09/06/12.
Becomes exercisable in equal annual installments of 20% commencing 06/27/08.
Becomes exercisable in equal annual installments of 20% commencing 05/21/09.
Becomes exercisable in equal annual installments of 20% commencing 08/11/12.
The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $14.54 to $14.67, 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.
Arlin D. Nelson
2012-09-07