-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, KizxLXSa/l+kjXniy2B4hRBe/SIrdNcqUjiREgIn1vnEyHRfj5ihuQkG8FVfLrKV ZQ2NOr/RaUy9u4NtIVDD4w== 0000931731-02-000033.txt : 20020414 0000931731-02-000033.hdr.sgml : 20020414 ACCESSION NUMBER: 0000931731-02-000033 CONFORMED SUBMISSION TYPE: SC 13G/A PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20020131 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: LAMPROPOULOS FRED P CENTRAL INDEX KEY: 0000901534 IRS NUMBER: 870447694 FILING VALUES: FORM TYPE: SC 13G/A BUSINESS ADDRESS: STREET 1: 1600 W MARIT PARKWAY CITY: SO JORDAN STATE: UT ZIP: 84095 BUSINESS PHONE: 84095-1688 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: MERIT MEDICAL SYSTEMS INC CENTRAL INDEX KEY: 0000856982 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 870447695 STATE OF INCORPORATION: UT FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G/A SEC ACT: 1934 Act SEC FILE NUMBER: 005-41418 FILM NUMBER: 02523718 BUSINESS ADDRESS: STREET 1: 1600 WEST MERIT PARK WAY CITY: SOUTH JORDAN STATE: UT ZIP: 84095 BUSINESS PHONE: 8012531600 MAIL ADDRESS: STREET 1: 1600 WEST MERIT PARKWAY CITY: SOUTH JORDAN STATE: UT ZIP: 84095 SC 13G/A 1 merit13ga11.txt OMB APPROVAL ------------------------------------- OMB Number 3235-0145 Expire October 31, 2002 Estimated average burden hours per response..............14.90 ------------------------------------- UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 SCHEDULE 13G Under the Securities Exchange Act of 1934 (Amendment No. 11)* Merit Medical Systems, Inc. - -------------------------------------------------------------------------------- (Name of Issuer) Common Stock, No Par Value - -------------------------------------------------------------------------------- (Title of Class of Securities) 589889-10-4 ------------- (CUSIP Number) December 31, 2001 ----------------------------------------- (Date of Event Which Requires Filing of this Statement) Check the appropriate box to designate the rule pursuant to which this Schedule is filed: [ ] Rule 13d-1(b) [ ] Rule 13d-1(c) [X] Rule 13d-1(d) *The remainder of this cover page shall be filled out for a reporting person's initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter the disclosures provided in a prior cover page. The information required in the remainder of this cover page shall not be deemed to be "filed" for the purpose of Section 18 of the Securities Exchange Act of 1934 ("Act") or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes). 1 CUSIP No. 589889-10-4 - -------------------------------------------------------------------------------- 1. Names of Reporting Persons. I.R.S. Identification Nos. of above persons (entities only). Fred P. Lampropoulos - -------------------------------------------------------------------------------- 2. Check the Appropriate Box if a Member of a Group (See Instructions) (a) [ ] (b) [ ] - -------------------------------------------------------------------------------- 3. SEC Use Only ----------------------------------------------------------- - -------------------------------------------------------------------------------- 4. Citizenship or Place of Organization United States ---------------- - -------------------------------------------------------------------------------- Number of 5. Sole Voting Power 766,379 Shares Bene- ficially 6. Shared Voting Power None Owned by Each Reporting 7. Sole Dispositive Power 766,379 Person With: 8. Shared Dispositive Power None - -------------------------------------------------------------------------------- 9. Aggregate Amount Beneficially Owned by Each Reporting Person 766,379 ------------ 10. Check if the Aggregate Amount in Row (9) Excludes Certain Shares (See Instructions) [ ] 11. Percent of Class Represented by Amount in Row (9) 7.1% --------- 12. Type of Reporting Person (See Instructions) IN ----- 2 CUSIP No. 589889-10-4 - -------------------------------------------------------------------------------- Item 1. (a) Name of Issuer: Merit Medical Systems, Inc. (b) Address of Issuer's Principal Executive Offices: 1600 West Merit Parkway, South Jordan, UT 84095 Item 2. (a) Name of Persons Filing: Fred P. Lampropoulos (the "Reporting Person") (b) Address of Principal Business Office, if none, Residence: 1600 West Merit Parkway, South Jordan, UT 84095 (c) Citizenship: United States (d) Title of Class of Securities: Common Stock, No Par Value (the "Common Stock") (e) CUSIP Number: 589889-10-4 Item 3. This statement is not filed pursuant to Sections 240.13d-1(b) or 240.13d-2(b) or (c). Item 4. Ownership (a) Amount Beneficially Owned: As of December 31, 2001, the Reporting Person was the beneficial owner of 766,379 shares of the Common Stock, which included 23,546 shares owned by the Reporting Person pursuant to the Issuer's 401(k) Plan, based upon the most recent plan statement timely distributed, and 215,625 shares that the Reporting Person had the right to acquire pursuant to options that were exercisable as of December 31, 2001 or exercisable within the sixty (60) day period following December 31, 2001. (b) Percent of Class: 7.1% (c) Number of shares as to which the person has: (i) Sole power to vote or to direct the vote: 766,379 shares of the Common Stock (ii) Shared power to vote or to direct the vote: None (iii) Sole power to dispose or to direct the disposition of: 766,379 shares of the Common Stock (iv) Shared power to dispose or to direct the disposition of: None Item 5. Ownership of Five Percent or Less of a Class Not applicable. Item 6. Ownership of More than Five Percent on Behalf of Another Person Not applicable. Item 7. Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on By the Parent Holding Company or Control Person Not applicable. 3 CUSIP No. 589889-10-4 - -------------------------------------------------------------------------------- Item 8. Identification and Classification of Members of the Group Not applicable. Item 9. Notice of Dissolution of Group Not applicable. Item 10. Certifications Not applicable. 4 SIGNATURE After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct. DATED: January 29, 2002 /s/ FRED P. LAMPROPOULOS ------------------------ Signature Fred P. Lampropoulos -------------------- Name/Title 6 -----END PRIVACY-ENHANCED MESSAGE-----