Sec Form 4 Filing - EDELMAN RICHARD W @ MERIT MEDICAL SYSTEMS INC - 2017-05-24

Insider filing report for Changes in Beneficial Ownership
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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
EDELMAN RICHARD W
2. Issuer Name and Ticker or Trading Symbol
MERIT MEDICAL SYSTEMS INC [ MMSI]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X __ Director _____ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
(Last) (First) (Middle)
1600 W. MERIT PARKWAY
3. Date of Earliest Transaction (MM/DD/YY)
05/24/2017
(Street)
SOUTH JORDAN, UT84095
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, No Par Value 05/24/2017( 1 ) M 11,621 ( 2 ) A $ 13.16 17,621 D
Common Stock, No Par Value 05/24/2017( 1 ) S 7,437 ( 2 ) D $ 34.5 10,184 D
Common Stock, No Par Value 05/25/2017( 1 ) M 13,379 ( 3 ) A $ 13.16 23,563 D
Common Stock, No Par Value 05/25/2017( 1 ) S 8,563 ( 3 ) D $ 34.42 ( 4 ) 15,000 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
Non-qualified stock options (right to buy) $ 13.16 05/24/2017 M 11,621 06/25/2011( 5 ) 06/25/2017 Common Stock 11,621 $ 0 13,379 D
Non-qualified stock options (right to buy) $ 13.16 05/25/2017 M 13,379 06/25/2011( 5 ) 06/25/2017 Common Stock 13,379 $ 0 0 D
Non-qualified stock options (right to buy) $ 13.75 08/11/2012( 6 ) 08/11/2018 Common Stock 20,000 20,000 D
Non-qualified stock options (right to buy) $ 12.91 05/23/2013( 7 ) 05/23/2019 Common Stock 20,000 20,000 D
Non-qualified stock options (right to buy) $ 9.95 05/22/2014( 8 ) 05/22/2020 Common Stock 25,000 25,000 D
Non-qualified stock options (right to buy) $ 13.99 06/11/2015( 9 ) 06/11/2021 Common Stock 25,000 25,000 D
Non-qualified stock options (right to buy) $ 20.27 05/22/2016( 10 ) 05/22/2022 Common Stock 25,000 25,000 D
Non-qualified stock options (right to buy) $ 18.8 05/26/2017( 11 ) 05/26/2023 Common Stock 25,000 25,000 D
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
EDELMAN RICHARD W
1600 W. MERIT PARKWAY
SOUTH JORDAN, UT84095
X
Signatures
Brian G. Lloyd, Attorney-in-Fact 05/26/2017
Signature of Reporting Person Date
Explanation of Responses:
( 1 )The Reporting Person ceased to be a director of the Issuer on March 24, 2017.
( 2 )The Reporting Person paid the exercise price on a cashless basis, resulting in the Issuer's withholding of 7,437 of such shares to pay the exercise price and taxes and issuing the remaining 4,184 shares to the Reporting Person.
( 3 )The Reporting Person paid the exercise price on a cashless basis, resulting in the Issuer's withholding of 8,563 of such shares to pay the exercise price and taxes and issuing the remaining 4,816 shares to the Reporting Person.
( 4 )The price reported in Column 4 of Table 1 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $34.40 to 34.50, inclusive. The Reporting Person undertakes to provide to Issuer, any security holder of Issuer, 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.
( 5 )Became exercisable in equal annual installments of 20% commencing 06/25/2011.
( 6 )Became exercisable in equal annual installments of 20% commencing 08/11/2012.
( 7 )Became exercisable in equal annual i nstallments of 20% commencing 05/23/2013.
( 8 )Became exercisable in equal annual installments of 20% commencing 05/22/2014. Installments scheduled for vesting after 5/22/2017 will not be exercisable.
( 9 )Became exercisable in equal annual installments of 20% commencing 06/11/2015. Installments scheduled for vesting after 6/11/2017 will not be exercisable.
( 10 )Became exercisable in equal annual installments of 20% commencing 05/22/2016. Installments scheduled for vesting after 5/22/2017 will not be exercisable.
( 11 )Became exercisable in equal annual installments of 20% commencing 05/26/2017. Installments scheduled for vesting after 5/26/2017 will not be exercisable.

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