0001127602-12-027968.txt : 20121002 0001127602-12-027968.hdr.sgml : 20121002 20121002174003 ACCESSION NUMBER: 0001127602-12-027968 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20121001 FILED AS OF DATE: 20121002 DATE AS OF CHANGE: 20121002 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: DeSisto Duane CENTRAL INDEX KEY: 0001395777 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33462 FILM NUMBER: 121124693 MAIL ADDRESS: STREET 1: C/O INSULET CORPORATION STREET 2: 9 OAK PARK DRIVE CITY: BEDFORD STATE: MA ZIP: 01730 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: INSULET CORP CENTRAL INDEX KEY: 0001145197 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 043523891 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 9 OAK PARK DRIVE CITY: BEDFORD STATE: MA ZIP: 01730 BUSINESS PHONE: (781) 457-5000 MAIL ADDRESS: STREET 1: 9 OAK PARK DRIVE CITY: BEDFORD STATE: MA ZIP: 01730 4 1 form4.xml PRIMARY DOCUMENT X0306 4 2012-10-01 0001145197 INSULET CORP PODD 0001395777 DeSisto Duane C/O INSULET CORPORATION 9 OAK PARK DRIVE BEDFORD MA 01730 1 1 President and CEO Common Stock 2012-10-01 4 M 0 20000 3.60 A 161077 D Common Stock 2012-10-01 4 S 0 20000 21.4347 D 141077 D Employee Stock Option (Right to Buy) 3.60 2012-10-01 4 M 0 20000 0 D 2015-02-09 Common Stock 20000 145527 D Includes an aggregate of 7,778 shares acquired under the Insulet Corporation 2007 Employee Stock Purchase Plan on the following dates: 219 shares acquired on December 31, 2007; 694 shares acquired on June 30, 2008; 1,429 shares acquired on December 31, 2008; 1,431 shares acquired on June 30, 2009; 772 shares acquired on December 31, 2009; 749 shares acquired on June 30, 2010; 732 shares acquired on December 31, 2010; 532 shares acquired on June 30, 2011; 640 shares acquired on December 30, 2011; and 580 shares acquired on June 29, 2012. Includes 13,334 restricted stock units granted on March 1, 2010 which vest on March 1, 2013; 26,667 restricted stock units granted on March 1, 2011 which vest one-half of the total units on March 1, 2013 and one-half of the total units on March 1, 2014; and 70,000 restricted stock units granted on April 1, 2012 which vest one-quarter of the total units on April 1, 2013, one-quarter of the total units on April 1, 2014, one-quarter of the total units on April 1, 2015 and one-quarter of the total units on April 1, 2016. Vested shares will be delivered to the reporting person as soon as practiable following a vesting date. The sales reported in this Form 4 were effected pursuant to a Rule 10b5-1 trading plan adopted by the reporting person on March 11, 2011. The price reported represents the weighted average sale price of the shares sold. The shares were sold at varying prices in the range of $21.20 to $21.75. The Reporting Person hereby undertakes, upon request of the Staff of the U.S. Securities Exchange Commission, the Issuer or a security holder of the Issuer, to provide full information regarding the number of shares sold at each separate price. This option may be exercised at any time, whether vested or not, but, upon termination of employment, we may repurchase any unvested shares at the exercise price paid for the shares. This option is subject to a four-year vesting period, with 25% of the total award vesting one year after the grant date and the remainder vesting in equal monthly installments each month thereafter for 36 months, subject to continued employment. /s/ R. Anthony Diehl, attorney in fact 2012-10-02