Filing Details

Accession Number:
0001179110-12-014374
Form Type:
4
Zero Holdings:
No
Publication Time:
2012-09-21 17:18:52
Reporting Period:
2012-09-19
Filing Date:
2012-09-21
Accepted Time:
2012-09-21 17:18:52
SEC Url:
Form 4 Filing
Issuer
Cik Name Symbol Sector (SIC) IRS No
856982 Merit Medical Systems Inc MMSI Surgical & Medical Instruments & Apparatus (3841) 870447695
Insiders
Cik Name Reported Address Insider Title Director Officer Large Shareholder Other
1184930 C Rex Bean 1600 W Merit Parkway
South Jordan UT 84095
Yes No No No
Reported Non-Derivative Transactions
Sec. Name Acquisiton - Disposition Date Amount Price Remaning Holdings Equity Swap Involved Form Type Code Nature of Ownership Explanation
Common Stock, No Par Value Acquisiton 2012-09-19 5,977 $8.38 5,977 No 4 M Direct
Common Stock, No Par Value Disposition 2012-09-19 5,977 $15.11 0 No 4 S Direct
Common Stock, No Par Value Acquisiton 2012-09-20 26,801 $8.38 26,801 No 4 M Direct
Common Stock, No Par Value Disposition 2012-09-20 26,801 $15.00 0 No 4 S Direct
Equity Swap Involved Form Type Code Nature of Ownership Explanation
No 4 M Direct
No 4 S Direct
No 4 M Direct
No 4 S Direct
Reported Derivative Transactions
Sec. Name Sec. Type Acquisiton - Disposition Date Amount Price Amount - 2 Price - 2
Common Stock Non-qualified stock options (right to buy) Disposition 2012-09-19 5,977 $0.00 5,977 $8.38
Common Stock Non-qualified stock options (right to buy) Disposition 2012-09-20 26,801 $0.00 26,801 $8.38
Remaning Holdings Exercise Date Expiration Date Equity Swap Involved Transaction Form Type Transaction Code Nature of Ownership
26,801 2003-05-22 2013-05-22 No 4 M Direct
0 2003-05-22 2013-05-22 No 4 M Direct
Reported Non-Derivative Holdings
Sec. Name Remaning Holdings Nature of Ownership Explanation
Common Stock, No Par Value 60,696 Indirect Rex C. Bean Trust dated 8/8/02
Common Stock, No Par Value 158,279 Indirect Bean Family Investments, LLC
Common Stock, No Par Value 500 Indirect Bean Family Foundation
Common Stock, No Par Value 55,203 Indirect Rex C. Bean Charitable Remainder Trust
Common Stock, No Par Value 35,149 Indirect Bean Family Revocable Trust dated 6/24/94
Reported Derivative Holdings
Sec. Name Sec. Type Price Date Expiration Date Amount Remaning Holdings Nature of Ownership
Common Stock Non-qualified stock options (right to buy) $17.34 2003-12-13 2013-12-13 18,750 18,750 Direct
Common Stock Non-qualified stock optons (right to buy) $11.05 2004-06-10 2014-06-10 18,750 18,750 Direct
Common Stock Non-qualified stock options (right to buy) $11.41 2005-05-25 2015-05-25 18,750 18,750 Direct
Common Stock Non-qualified stock options (right to buy) $9.22 2006-05-25 2013-05-25 18,750 18,750 Direct
Common Stock Non-qualified stock options (right to buy) $9.70 2008-06-27 2014-06-27 18,750 18,750 Direct
Common Stock Non-qualified stock options (right to buy) $11.53 2009-05-21 2015-05-21 18,750 18,750 Direct
Common Stock Non-qualified stock options (right to buy) $13.82 2010-09-26 2016-09-26 25,000 25,000 Direct
Common Stock Non-qualified stock options (right to buy) $13.16 2011-06-25 2017-06-25 25,000 25,000 Direct
Common Stock Non-qualified stock options (right to buy) $13.75 2012-08-11 2018-08-11 20,000 20,000 Direct
Common Stock Non-qualified stock options (right to buy) $12.91 2013-05-23 2019-05-23 20,000 20,000 Direct
Expiration Date Amount Remaning Holdings Nature of Ownership
2013-12-13 18,750 18,750 Direct
2014-06-10 18,750 18,750 Direct
2015-05-25 18,750 18,750 Direct
2013-05-25 18,750 18,750 Direct
2014-06-27 18,750 18,750 Direct
2015-05-21 18,750 18,750 Direct
2016-09-26 25,000 25,000 Direct
2017-06-25 25,000 25,000 Direct
2018-08-11 20,000 20,000 Direct
2019-05-23 20,000 20,000 Direct
Footnotes
  1. Becomes exercisable in equal annual installments of 20% commencing 06/27/2008.
  2. Becomes exercisable in equal annual installments of 20% commencing 05/21/2009.
  3. Becomes exercisable in equal annual installments of 20% commencing 09/26/2010.
  4. Becomes exercisable in equal annual installments of 20% commencing 06/25/2011.
  5. Becomes exercisable in equal annual installments of 20% commencing 08/11/2012.
  6. Becomes exercisable in equal annual installments of 20% commencing 05/23/2013.
  7. The price reported in the second line of Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $15.10 to $15.12, inclusive. The reporting person undertakes to provide to Merit Medical Systems, Inc., any security holder of Merit Medical Systems, Inc., or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth in this Form 4.
  8. The price reported in the fourth line of Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $15.00 to $15.01, inclusive. The reporting person undertakes to provide to Merit Medical Systems, Inc., any security holder of Merit Medical Systems, Inc., or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth in this Form 4.