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