Sec Form 4 Filing - ROOT HOWARD @ VASCULAR SOLUTIONS INC - 2017-02-17

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FORM 4
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
ROOT HOWARD
2. Issuer Name and Ticker or Trading Symbol
VASCULAR SOLUTIONS INC [ VASC]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X __ Director _____ 10% Owner
X __ Officer (give title below) _____ Other (specify below)
Chief Executive Officer
(Last) (First) (Middle)
C/O VASCULAR SOLUTIONS, INC., 6464 SYCAMORE COURT NORTH
3. Date of Earliest Transaction (MM/DD/YY)
02/17/2017
(Street)
MINNEAPOLIS, MN55369
4. If Amendment, Date Original Filed (MM/DD/YY)
6. Individual or Joint/Group Filing (Check Applicable Line)
__ X __ Form filed by One Reporting Person
_____ Form filed by More than One Reporting Person
(City) (State) (Zip)
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Transaction Date (MM/DD/YY) 2A. Deemed Execution Date, if any (MM/DD/YY) 3. Transaction Code
(Instr. 8)
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4)
7. Nature of Indirect Beneficial Ownership
(Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 319,772 D
Common Stock 02/17/2017 D 319,772 D 0 D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
( e.g. , puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (MM/DD/YY) 3A. Deemed Execution Date, if any (MM/DD/YY) 4. Transaction Code
(Instr. 8)
5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4, and 5)
6. Date Exercisable and Expiration Date
(MM/DD/YY)
7. Title and Amount of Underlying Securities
(Instr. 3 and 4)
8. Price of Derivative Security
(Instr. 5)
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 4)
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 4)
11. Nature of Indirect Beneficial Ownership
(Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Stock Option (Right to Buy) ( 2 ) ( 3 ) ( 4 ) ( 5 ) 02/17/2017 D 360,000 ( 2 )( 3 )( 4 )( 5 ) 01/27/2022 Common Stock 360,000 ( 2 ) ( 3 ) ( 4 ) ( 5 ) 0 D
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
ROOT HOWARD
C/O VASCULAR SOLUTIONS, INC.
6464 SYCAMORE COURT NORTH
MINNEAPOLIS, MN55369
X Chief Executive Officer
Signatures
/s/ Howard C. Root 02/22/2017
Signature of Reporting Person Date
Explanation of Responses:
( 1 )In connection with the merger of Issuer and a subsidiary of Teleflex Incorporated (the "Merger") pursuant to an agreement and plan of merger dated December 1, 2016, all shares of Issuer common stock were canceled and automatically converted into the right to receive $56.00 per share in cash, without interest and less any applicable withholding taxes.
( 2 )90,000 shares, which vested on January 27, 2014 with an exercise price of $12.03 per share, were canceled pursuant to the Merger in exchange for a cash payment of $43.97 per share, or $3,957,300 in aggregate, which represents the difference between the exercise price of the option and the merger consideration per share ($56.00) multiplied by the total number of shares underlying the option, less any applicable withholding taxes.
( 3 )90,000 shares, which vested on January 27, 2015 with an exercise price of $13.03 per share, were canceled pursuant to the Merger in exchange for a cash payment of $42.97 per share, or $3,867,300 in aggregate, which represents the difference between the exercise price of the option and the merger consideration per share ($56.00) multiplied by the total number of shares underlying the option, less any applicable withholding taxes.
( 4 )90,000 shares, which vested on January 27, 2016 with an exercise price of $14.03 per share, were canceled pursuant to the Merger in exchange for a cash payment of $41.97 per share, or $3,777,300 in aggregate, which represents the difference between the exercise price of the option and the merger consideration per share ($56.00) multiplied by the total number of shares underlying the option, less any applicable withholding taxes.
( 5 )90,000 shares, which vested on January 27, 2017 with an exercise price of $15.03 per share, were canceled pursuant to the Merger in exchange for a cash payment of $40.97 per share, or $3,687,300 in aggregate, which represents the difference between the exercise price of the option and the merger consideration per share ($56.00) multiplied by the total number of shares underlying the option, less any applicable withholding taxes.

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