-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, DinnAABGDfzHOgXA+LeakWmEZyv/cmttz8jAeeNV/Vl1Sz7cyIzUCn0QtSFxLW5m EorLQ8LmkZ3/HKM2B1buOg== 0001225208-09-020704.txt : 20091020 0001225208-09-020704.hdr.sgml : 20091020 20091020160720 ACCESSION NUMBER: 0001225208-09-020704 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20091016 FILED AS OF DATE: 20091020 DATE AS OF CHANGE: 20091020 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: BOSTON SCIENTIFIC CORP CENTRAL INDEX KEY: 0000885725 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 042695240 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: ONE BOSTON SCIENTIFIC PL CITY: NATICK STATE: MA ZIP: 01760-1537 BUSINESS PHONE: 5086508000 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: NICHOLAS PETER M CENTRAL INDEX KEY: 0000901458 STATE OF INCORPORATION: MA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-11083 FILM NUMBER: 091128055 MAIL ADDRESS: STREET 1: C/O BOSTON SCIENTIFIC CORPORATION STREET 2: ONE BOSTON SCIENTIFIC PLACE CITY: NATICK STATE: MA ZIP: 01760-1537 4 1 doc4.xml X0303 4 2009-10-16 0000885725 BOSTON SCIENTIFIC CORP BSX 0000901458 NICHOLAS PETER M ONE BOSTON SCIENTIFIC PLACE NATICK MA 01760-1537 1 Forward Sale Contract (obligation to sell) 0 2009-10-16 4 J 0 125000 0 A 2011-10-17 2011-10-17 Common Stock 125000 125000 I By Ltd. Partnership On August 26, 2009, a family limited partnership of which the reporting person is a general and limited partner, Promerica L.P., entered into a Rule 10b5-1 trading plan with an unaffiliated commercial bank to execute a series of variable prepaid forward sale contracts. Under the contract reported on this form, Promerica will deliver to the bank up to 125,000 shares of the Issuer's common stock depending on market prices at maturity on October 17, 2011. If the market price per share at maturity is equal to or less than the floor price, Promerica will deliver 125,000 shares to the bank. If the market price per share at maturity is greater than the floor price, Promerica will deliver a fewer number of shares. The floor price will be determined by the bank based on the stock price on the first anniversary of the contract date. At the option of Promerica, the contract may be settled at maturity by delivering cash in lieu of stock. Under the contract represented on this form, the bank is obligated to pay $1,009,057.44 to Promerica two business days after the date of the contract. In addition, if the market price per share on the first anniversary of the contract date is equal to or greater than approximately $12.03, the bank is obligated to pay an additional amount, determined by the bank based on the stock price at the time, to the reporting person three business days after the anniversary. If the market price per share on the first anniversary of the contract date is less than approximately $12.03, the contract will then be terminated and the reporting person will deliver shares to the bank. If the market price per share upon an early termination is equal to or less than $10.0279 the reporting person will deliver 125,000 shares to the bank. If the market price per share upon an early termination is greater than $10.0279 the reporting person will deliver a fewer number of shares. Promerica pledged 125,000 shares of the Issuer's common stock to secure its obligations under the contract and retains dividends and voting rights in the shares during the term of the pledge. The reporting person disclaims beneficial ownership of this stock except to the extent of his pecuniary interest. /s/ Lawrence J. Knopf, Attorney-in-fact 2009-10-20 -----END PRIVACY-ENHANCED MESSAGE-----