0001179110-16-029673.txt : 20160914 0001179110-16-029673.hdr.sgml : 20160914 20160914170113 ACCESSION NUMBER: 0001179110-16-029673 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160912 FILED AS OF DATE: 20160914 DATE AS OF CHANGE: 20160914 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: LAMPROPOULOS FRED P CENTRAL INDEX KEY: 0000901534 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-18592 FILM NUMBER: 161885610 4 1 edgar.xml FORM 4 - X0306 4 2016-09-12 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 92460 I By 401(k) Plan Common Stock, No Par Value 90 I By spouse as custodian for child. Common Stock, No Par Value 11817 I By spouse. Common Stock, No Par Value 2016-09-12 4 M 0 25000 13.82 A 1088497 D Common Stock, No Par Value 2016-09-12 4 F 0 17628 24.50 D 1070869 D Non-qualified stock options (right to buy) 13.82 2016-09-12 4 M 0 25000 0 D 2010-09-26 2016-09-26 Common Stock 25000 0 D Non-qualified stock options (right to buy) 13.75 2012-08-11 2018-08-11 Common Stock 120000 120000 D Non-qualified stock options (right to buy) 12.06 2015-10-04 2021-10-04 Common Stock 50000 50000 D Non-qualified stock options (right to buy) 17.27 2016-02-13 2022-02-13 Common Stock 50000 50000 D Non-qualified stock options (right to buy) 17.27 2016-02-13 2022-02-13 Common Stock 5000 5000 I Please refer to footnote number six. Non-qualified stock options (right to buy) 16.05 2017-01-28 2023-01-28 Common Stock 7500 7500 I Please refer to footnote number six. Non-qualified stock options (right to buy) 16.05 2017-01-28 2023-01-28 Common Stock 50000 50000 D Represents plan holdings as of 9/13/2016. Becomes exercisable in equal annual installments of 20% commencing 9/26/2010. Becomes exercisable in equal annual installments of 20% commencing 8/11/2012. Becomes exercisable in equal annual installments of 20% commencing 10/4/2015. Becomes exercisable in equal annual installments of 20% commencing 2/13/2016. Represents derivative securities held by the spouse of the reporting person. The reporting person expressly disclaims beneficial ownership of the securities owned by his spouse. Becomes exercisable in equal annual installments of 20% commencing 1/28/2017. Stock options were exercised in a swap transaction with the Company. 17,628 shares of common stock were surrendered in payment of the option exercise price and assorted payroll tax liability. No shares were sold in the open market. Brian G. Lloyd, Attorney-in-Fact 2016-09-14