0000883984-12-000006.txt : 20120202 0000883984-12-000006.hdr.sgml : 20120202 20120202132614 ACCESSION NUMBER: 0000883984-12-000006 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20120201 FILED AS OF DATE: 20120202 DATE AS OF CHANGE: 20120202 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BROWN JACK CENTRAL INDEX KEY: 0001073393 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34634 FILM NUMBER: 12565299 MAIL ADDRESS: STREET 1: C/O ICU MEDICAL INC STREET 2: 951 CALLE AMANECER CITY: SAN CLEMENTE STATE: CA ZIP: 92673 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ICU MEDICAL INC/DE CENTRAL INDEX KEY: 0000883984 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 330022692 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 951 CALLE AMANECER CITY: SAN CLEMENTE STATE: CA ZIP: 92763-6212 BUSINESS PHONE: 949-366-2183 MAIL ADDRESS: STREET 1: 951 CALLE AMANECER CITY: SAN CLEMENTE STATE: CA ZIP: 92763-6212 4 1 edgardoc.xml PRIMARY DOCUMENT X0304 4 2012-02-01 0 0000883984 ICU MEDICAL INC/DE ICUI 0001073393 BROWN JACK 951 CALLE AMANECER SAN CLEMENTE CA 92673 1 0 0 0 Non-Qualified Stock Option (right to buy) 46.53 2012-02-01 2012-02-01 4 A 0 1875.0 46.53 A 2013-02-01 2022-02-01 Common Stock 1875.0 1875.0 D By: Lynn DeMartini For: Jack W. Brown 2012-02-02