0001179110-16-025772.txt : 20160531
0001179110-16-025772.hdr.sgml : 20160531
20160531190244
ACCESSION NUMBER: 0001179110-16-025772
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 2
CONFORMED PERIOD OF REPORT: 20160526
FILED AS OF DATE: 20160531
DATE AS OF CHANGE: 20160531
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
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Miller Franklin J
CENTRAL INDEX KEY: 0001327767
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-18592
FILM NUMBER: 161687495
MAIL ADDRESS:
STREET 1: 1600 WEST MERIT PARKWAY
CITY: SOUTH JORDAN
STATE: UT
ZIP: 84095
4
1
edgar.xml
FORM 4 -
X0306
4
2016-05-26
0
0000856982
MERIT MEDICAL SYSTEMS INC
MMSI
0001327767
Miller Franklin J
1600 W MERIT PARKWAY
SOUTH JORDAN
UT
84095
1
0
0
0
Common Stock, No Par Value
18193
I
By the Franklin J. Miller and Bonnie A. Miller Family Trust
Common Stock, No Par Value
2334
D
Non-qualified stock options (right to buy)
13.82
2010-09-26
2016-09-26
Common Stock
10000
15000
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
2014-05-22
2020-05-22
Common Stock
25000
25000
D
Non-qualified stock options (right to buy)
13.99
2015-06-11
2021-06-11
Common Stock
25000
25000
D
Non-qualified stock options (right to buy)
20.27
2016-05-22
2022-05-22
Common Stock
25000
25000
D
Non-qualified stock options (right to buy)
18.80
2016-05-26
4
A
0
25000
0
A
2017-05-26
2023-05-26
Common Stock
25000
25000
D
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.
Becomes exercisable in equal annual installments of 20% commencing 05/22/2014.
Becomes exercisable in equal annual installments of 20% commencing 06/11/2015.
Becomes exercisable in equal annual installments of 20% commencing 05/22/2016.
Becomes exercisable in equal annual installments of 20% commencing 05/26/2017.
Brian G. Lloyd, Attorney-in-Fact
2016-05-31
EX-24.2
2
millerpoatext.txt
POWEROFATTORNEY
MERIT MEDICAL SYSTEMS, INC.
POWER OF ATTORNEY
For Executing Forms 3, 4 and 5
Knowing all by these presents that the undersigned hereby constitutes
and appoints each of Fred P. Lampropoulos, Bernard Birkett and Brian
LLoyd signing singly, his/hers true and lawful attorney-in-fact to:
(1) prepare, execute in the undersigned's name and on the undersigned's
behalf, and submit to the U.S. Securities and Exchange Commission a
Form ID, including amendments thereto, and any other documents necessary
or appropriate to obtain codes and passwords enabling the undersigned
to make electronic filings with the SEC of reports required by Section
16(a) of the Securities Exchange Act of 1934 or any rule or regulation of
the SEC;
(2) execute for and on behalf of the undersigned, in the undersigned's
capacity as an office and/or director of Merit Medical Systems, Inc.,
Forms 3, 4, and 5 in accordance with Section 16(a) of the Securities
Exchange Act of 1934 and the rules thereunder, and any other forms or
reports the undersigned may be required to file in connection with the
undersigned's ownership, acquisition or disposition of securities of
Merit Medical Systems, Inc.;
(3) do and perform any and all acts for and on behalf of the undersigned
which may be necessary or desirable to complete and execute any such
Form 3, 4, or 5 or other form or report, and timely file such form or
report with the U.S. Securities and Exchange Commission and any stock
exchange or similar authority; and
(4) take any other action of any type whatsoever in connection with
the foregoing which, in the opinion of such attorney-in-fact, may be
of benefit to, in the best interest of, or legally required by, the
undersigned, it being understood that the documents executed by such
attorney-in-fact on behalf of the undersigned pursuant to this Power
of Attorney shall be in such form and shall contain such terms and
conditions as such attorney-in-fact may approve in such attorney-in-fact's
discretion.
The undersigned hereby grants to each such attorney-in-fact full power
and authority to do and perform any and every act and thing whatsoever
requisite, necessary or proper to be done in the exercise of any of the
rights and powers herein granted, as fully to all intents and purposes
as the undersigned might or could do if personally present, with full
power of substitution or revocation, hereby ratifying and confirming all
that such attorney-in-fact, or his/her substitute or substitutes, shall
lawfully do or cause to be done by virtue of this power of attorney and
the rights and powers herein granted. The undersigned acknowledges that
the foregoing attorneys-in-fact, in serving in such capacity at the request
of the undersigned, are not assuming, nor is Merit Medical Systems, Inc.
assuming, any of the undersigned's responsibilities to comply with Section
16 of the Securities Exchange Act of 1934.
This Power of Attorney shall remain in full force and effect until the
undersigned is no longer required to file Forms 3, 4 and 5 with respect
to the undersigned's holdings of and transactions in securities issued
by Merit Medical Systems, Inc., unless earlier revoked by the undersigned
in a signed writing delivered to the foregoing attorneys-in-fact.
Photographic copies of this Power of Attorney shall have the same force
and effects as the original.
IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney
to be executed as of this 24 day of February, 2016.
/s/ Franklin J. Miller
Signature
Franklin J. Miller
Printed Name