0001127602-12-018081.txt : 20120524 0001127602-12-018081.hdr.sgml : 20120524 20120524171825 ACCESSION NUMBER: 0001127602-12-018081 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20120522 FILED AS OF DATE: 20120524 DATE AS OF CHANGE: 20120524 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Diehl R Anthony CENTRAL INDEX KEY: 0001395783 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33462 FILM NUMBER: 12868520 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 X0305 4 2012-05-22 0001145197 INSULET CORP PODD 0001395783 Diehl R Anthony C/O INSULET CORPORATION 9 OAK PARK DRIVE BEDFORD MA 01730 1 Secretary and General Counsel Common Stock 2012-05-22 4 M 0 9831 3.60 A 59786 D Common Stock 2012-05-22 4 S 0 9831 18.6193 D 49955 D Employee Stock Option (Right to Buy) 3.60 2012-05-22 4 M 0 9831 0 D 2015-05-04 Common Stock 9831 0 D 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. The price reported represents the weighted average sale price of the shares sold. The shares were sold at varying prices in the range of $18.60 to $18.72. 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 informaiton regarding the number of shares sold at each separate price. Includes 5,334 restricted stock units granted on March 1, 2010 which vest on March 1, 2013; 12,000 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 20,000 restricted stock units granted on April 1, 2012 which vest one-quarter of the total units on the first anniversary date of the grant and one-quarter each on the second, third and fourth anniversaries of the date of grant. Vested shares will be delivered to the reporting person as soon as practicable following a vesting date. Includes an aggregate of 1,249 shares acquired under the Insulet Corporation 2007 Employee Stock Purchase Plan on the following dates: 400 shares acquired on December 31, 2007; and 849 shares acquired on June 30, 2008. The sales reported in this Form 4 were effected pursuant to a Rule 10b5-1 trading plan adopted by the reporting person on February 17, 2012. /s/ R. Anthony Diehl 2012-05-23