0001410442-21-000006.txt : 20210309 0001410442-21-000006.hdr.sgml : 20210309 20210309211846 ACCESSION NUMBER: 0001410442-21-000006 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210306 FILED AS OF DATE: 20210309 DATE AS OF CHANGE: 20210309 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Jain Vivek CENTRAL INDEX KEY: 0001410442 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34634 FILM NUMBER: 21728013 MAIL ADDRESS: STREET 1: 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 X0306 4 2021-03-06 0 0000883984 ICU MEDICAL INC/DE ICUI 0001410442 Jain Vivek 951 CALLE AMANECER SAN CLEMENTE CA 92673 1 1 0 0 Chairman and CEO Common Stock 2021-03-06 4 M 0 2681 0.0 A 12731 D Common Stock 2021-03-06 4 F 0 1411 0.0 D 11320 D Common Stock 2021-03-06 4 M 0 1444 0.0 A 12764 D Common Stock 2021-03-06 4 F 0 760 0.0 D 12004 D Common Stock 2021-03-06 4 M 0 1772 0.0 A 13776 D Common Stock 2021-03-06 4 F 0 932 0.0 D 12844 D Common Stock 60000 I by Trust Common Stock 0.0 2021-03-06 4 M 0 1772 0.0 D 2023-03-06 Common Stock 1772 3545 D Common Stock 0.0 2021-03-08 4 A 0 7574 0.0 A 2024-03-08 Common Stock 7574 7574 D Common Stock 2021-03-06 4 M 0 2681 0.0 D 2021-03-06 Common Stock 2681 0 D Common Stock 2021-03-06 4 M 0 1444 0.0 D 2022-03-06 Common Stock 1444 1444 D These securities are Restricted Stock Units. This transaction represented a gift of securities from the reporting person to two trusts for the benefit of family members, who share the same household. The reporting person disclaims beneficial ownership of the shares held by the trusts, and this report shall not be deemed as an admission that the reporting person is the beneficial owner of the trust's shares for purposes of Section 16 or for any other purpose. There is neither a purchase price nor an exercise price for the Restricted Stock Units. One third of the units subject to the award shall vest on each of the first, second, and third anniversaries of the grant date. These are restricted stock units that fully vest 3 years from the grant date. By: Paula Darbyshire, Attorney-in-fact For: Vivek Jain 2021-03-09