0001127602-23-016718.txt : 20230524 0001127602-23-016718.hdr.sgml : 20230524 20230524161441 ACCESSION NUMBER: 0001127602-23-016718 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230523 FILED AS OF DATE: 20230524 DATE AS OF CHANGE: 20230524 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Petrovic Shacey CENTRAL INDEX KEY: 0001631895 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33462 FILM NUMBER: 23954291 MAIL ADDRESS: STREET 1: 600 TECHNOLOGY PARK DRIVE STREET 2: SUITE 200 CITY: BILLERICA STATE: MA ZIP: 01821 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: 100 NAGOG PARK CITY: ACTON STATE: MA ZIP: 01720 BUSINESS PHONE: 978-600-7000 MAIL ADDRESS: STREET 1: 100 NAGOG PARK CITY: ACTON STATE: MA ZIP: 01720 4 1 form4.xml PRIMARY DOCUMENT X0407 4 2023-05-23 0001145197 INSULET CORP PODD 0001631895 Petrovic Shacey C/O INSULET CORPORATION 100 NAGOG PARK ACTON MA 01720 1 0 Common Stock 2023-05-23 4 A 0 843 0 A 2567 D Common Stock 58205 I By NG Trust Common Stock 12925 I By SP Trust Annual equity award in the form of restricted stock units ("RSUs"). These RSUs vest in full on April 30, 2024 and are settled in shares of common stock on a one-for-one basis. Does not include 6,139 previously reported unvested restricted stock units ("RSUs"). These unvested RSUs were forfeited when Ms. Petrovic ceased to be an employee of the Registrant. /s/ Patricia K. Dolan, attorney-in-fact 2023-05-24