0001179110-20-000862.txt : 20200129
0001179110-20-000862.hdr.sgml : 20200129
20200129110519
ACCESSION NUMBER: 0001179110-20-000862
CONFORMED SUBMISSION TYPE: 5
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20191231
FILED AS OF DATE: 20200129
DATE AS OF CHANGE: 20200129
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Miller Franklin J
CENTRAL INDEX KEY: 0001327767
FILING VALUES:
FORM TYPE: 5
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-18592
FILM NUMBER: 20556933
MAIL ADDRESS:
STREET 1: 1600 WEST 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
5
1
edgar.xml
FORM 5 -
X0306
5
2019-12-31
0
0
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
29897
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)
9.95
2014-05-22
2020-05-22
Common Stock
20000
20000
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
2017-05-26
2023-05-26
Common Stock
25000
25000
D
Non-qualified stock options (right to buy)
34.40
2018-05-24
2024-05-24
Common Stock
25000
25000
D
Non-qualified stock options (right to buy)
50.5
2019-06-07
2025-06-07
Common Stock
25000
25000
D
Non-qualified stock options (right to buy)
52.17
2020-05-24
2026-05-24
Common Stock
13750
13750
D
Non-qualified stock options (right to buy)
52.17
2020-05-31
2026-05-31
Common Stock
7500
7500
D
This Form 5 is being filed to report the transfer of 11,704 shares transferred into the Franklin J. Miller and Bonnie A. Miller Family Trust from the reporting person's directly held shares, a transaction exempt form Section 16 reporting pursuant to Rule 16a-13.
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.
Becomes exercisable in equal annual installments of 20% commencing 05/24/2018.
Becomes exercisable in equal annual installments of 20% commencing 06/07/2019.
Becomes exercisable in equal annual installments of 20% commencing 05/24/2020.
Becomes exercisable in equal annual installments of 20% commencing 05/31/2020.
Brian G. Lloyd, Attorney-in-Fact
2020-01-29