Sec Form 4 Filing - LAMPROPOULOS FRED P @ MERIT MEDICAL SYSTEMS INC - 2021-09-08

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
LAMPROPOULOS FRED P
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
X __ Officer (give title below) _____ Other (specify below)
PRESIDENT AND CEO
(Last) (First) (Middle)
1600 WEST MERIT PARKWAY
3. Date of Earliest Transaction (MM/DD/YY)
09/08/2021
(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 09/08/2021 M 5,000 A $ 17.27 6,269 I By spouse ( 1 )
Common Stock, No Par Value 09/08/2021 F 2,410 D $ 72.23 3,859 I By spouse ( 1 )
Common Stock, No Par Value 967,916 D
Common Stock, No Par Value 95,919 I By 401(k) Plan ( 2 )
Common Stock, No Par Value 90 I By spouse as custodian for child ( 1 )
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) $ 17.27 09/08/2021 M 5,000 02/13/2016( 3 ) 02/13/2022 Common Stock 5,000 $ 0 0 I See footnote ( 1 )
Non-qualified stock options (right to buy) $ 16.05 01/28/2017( 4 ) 01/28/2023 Common Stock 50,000 50,000 D
Non-qualified stock options (right to buy) $ 16.05 01/28/2017( 5 ) 01/28/2023 Common Stock 6,000 6,000 I See footnote ( 1 )
Non-qualified stock options (right to buy) $ 28.2 04/14/2018( 6 ) 04/14/2024 Common Stock 200,000 200,000 D
Non-qualified stock options (right to buy) $ 28.2 04/14/2018( 7 ) 04/14/2024 Common Stock 6,000 6,000 I See footnote ( 1 )
Non-qualified stock options (right to buy) $ 44.8 03/02/2019( 8 ) 03/02/2025 Common Stock 38,002 38,002 D
Non-qualified stock options (right to buy) $ 44.8 03/02/2019( 9 ) 03/02/2025 Common Stock 4,000 4,000 I See footnote ( 1 )
Non-qualified stock options (right to buy) $ 55.73 03/01/2020( 10 ) 03/01/2026 Common Stock 159,151 159,151 D
Non-qualified stock options (right to buy) $ 55.73 03/01/2020( 11 ) 03/01/2026 Common Stock 2,000 2,000 I See footnote ( 1 )
Non-qualified stock options (right to buy) $ 37.71 02/26/2021( 12 ) 02/26/2027 Common Stock 100,334 100,334 D
Non-qualified stock options (right to buy) $ 56.25 03/19/202 2( 13 ) 03/19/2028 Common Stock 58,083 58,083 D
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
LAMPROPOULOS FRED P
1600 WEST MERIT PARKWAY
SOUTH JORDAN, UT84095
X PRESIDENT AND CEO
Signatures
/s/ Brian G. Lloyd, Attorney-in-Fact 09/10/2021
Signature of Reporting Person Date
Explanation of Responses:
( 1 )Represents securities held by the spouse of the reporting person. The reporting person expressly disclaims beneficial ownership of the securities owned by his spouse.
( 2 )Represents plan holdings as of 9/10/2021.
( 3 )Became exercisable in equal annual installments of 20% commencing 2/13/2016.
( 4 )Became exercisable in equal annual installments of 20% commencing 1/28/2017.
( 5 )Original grant of 7,500 options was to become vested and exercisable in equal annual installments of 20% commencing 1/28/2017. Options not vested as of 6/22/2020 have been forfeited.
( 6 )Becomes exercisable in equal annual installments of 20% commencing 4/14/2018.
( 7 )Original grant of 10,000 options was to become vested and exercisable in equal annual installments of 20% commencing 4/14/2018. Options not vested as of 6/22/2020 have been forfeited.
( 8 )Becomes exercisable in equal annual installments of 20% commencing 3/2/2019.
( 9 )Original grant of 10,000 options was to become vested and exercisable in equal annual installments of 20% commencing 3/2/2019. Options not vested as of 6/22/2020 have been forfeited.
( 10 )Becomes exercisable in equal annual installments of 20% commencing 3/1/2020.
( 11 )Original grant of 10,000 options was to become vested and exercisable in equal annual installments of 20% commencing 3/1/2020. Options not vested as of 6/22/2020 have been forfeited.
( 12 )Becomes exercisable in equal annual installments of 25% commencing 2/26/2021.
( 13 )Becomes exercisable in equal annual installments of 25% commencing 3/19/2022.

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