0001179110-13-008991.txt : 20130523 0001179110-13-008991.hdr.sgml : 20130523 20130523174935 ACCESSION NUMBER: 0001179110-13-008991 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20130521 FILED AS OF DATE: 20130523 DATE AS OF CHANGE: 20130523 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BEAN REX C CENTRAL INDEX KEY: 0001184930 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-18592 FILM NUMBER: 13869587 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 2013-05-21 1 0000856982 MERIT MEDICAL SYSTEMS INC MMSI 0001184930 BEAN REX C 1600 W MERIT PARKWAY SOUTH JORDAN UT 84095 1 0 0 0 Common Stock, No Par Value 46696 I Rex C. Bean Trust dated 8/8/02 Common Stock, No Par Value 158279 I Bean Family Investments, LLC Common Stock, No Par Value 500 I Bean Family Foundation Common Stock, No Par Value 69203 I Rex C. Bean Charitable Remainder Trust Common Stock, No Par Value 35149 I Bean Family Revocable Trust dated 6/24/94 Common Stock, No Par Value 2013-05-21 4 M 0 8500 9.22 A 8500 D Common Stock, No Par Value 2013-05-21 4 S 0 8500 10.08 D 0 D Common Stock, No Par Value 2013-05-22 4 M 0 4500 9.22 A 4500 D Common Stock, No Par Value 2013-05-22 4 S 0 4500 10.095 D 0 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) 9.70 2008-06-27 2014-06-27 Common Stock 18750 18750 D Non-qualified stock options (right to buy) 9.22 2013-05-21 4 M 0 8500 0 D 2006-05-25 2013-05-25 Common Stock 8500 10250 D Non-qualified stock options (right to buy) 9.22 2013-05-22 4 M 0 4500 0 D 2006-05-25 2013-05-25 Common Stock 4500 5750 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 Non-qualified stock options (right to buy) 12.91 2013-05-23 2019-05-23 Common Stock 20000 20000 D Non-qualified stock options (right to buy) 9.95 2013-05-22 4 A 0 25000 0 A 2014-05-22 2020-05-22 CommonStock 25000 25000 D Becomes exercisable in equal annual installments of 20% commencing 06/27/2008. Becomes exercisable in equal annual installments of 20% commencing 05/21/2009. Becomes exercisable in equal annual installments of 20% commencing 09/26/2010. Becomes exercisable in equal annual installments of 20% commencing 06/25/2011. Becomes exercisable in equal annual installments of 20% commencing 08/11/2012. Becomes exercisable in equal annual installments of 20% commencing 05/23/2013. The price reported in the second line of Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $10.08 to $10.11, 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. Becomes exercisable in equal annual installments of 20% commencing 05/22/2014. Gregory L. Barnett, Attorney-in-Fact 2013-05-23