0000883984-12-000066.txt : 20120515 0000883984-12-000066.hdr.sgml : 20120515 20120515202247 ACCESSION NUMBER: 0000883984-12-000066 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20120511 FILED AS OF DATE: 20120515 DATE AS OF CHANGE: 20120515 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: 12847029 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 X0305 4 2012-05-11 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) 53.81 2012-05-11 4 A 0 1508.0 53.81 A 2013-05-11 2022-05-11 Common Stock 1508.0 1508.0 D Non-Qualified Stock Option (right to buy) 2012-05-11 4 A 0 1022.0 A 2013-05-11 Common Stock 1022.0 1022.0 D These securities are Restricted Stock Units. There is neither a purchase price nor an exercise price for the Restricted Stock Units. These Restricted Stock Units vest on the anniversary of the date of the award. By: Lynn DeMartini For: Jack W. Brown 2012-05-15