0001209191-17-014477.txt : 20170224 0001209191-17-014477.hdr.sgml : 20170224 20170224175333 ACCESSION NUMBER: 0001209191-17-014477 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170222 FILED AS OF DATE: 20170224 DATE AS OF CHANGE: 20170224 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: LEMAITRE VASCULAR INC CENTRAL INDEX KEY: 0001158895 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 000000000 FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 63 SECOND AVENUE CITY: BURLINGTON STATE: MA ZIP: 01803 BUSINESS PHONE: 781-221-2266 MAIL ADDRESS: STREET 1: 63 SECOND AVENUE CITY: BURLINGTON STATE: MA ZIP: 01803 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: LeMaitre George W CENTRAL INDEX KEY: 0001365737 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33092 FILM NUMBER: 17638833 MAIL ADDRESS: STREET 1: 342 BUNKER HILL STREET, #2B CITY: CHARLESTOWN STATE: MA ZIP: 02129 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2017-02-22 0 0001158895 LEMAITRE VASCULAR INC LMAT 0001365737 LeMaitre George W C/O LEMAITRE VASCULAR, INC. 63 SECOND AVENUE BURLINGTON MA 01803 1 1 1 0 Chairman and CEO Common Stock 2017-02-22 4 M 0 18271 6.85 A 3396334 D Common Stock 2017-02-22 4 M 0 55360 7.34 A 3451694 D Common Stock 92030 I See footnote Stock Option (Right to Buy) 6.85 2017-02-22 4 M 0 18271 0.00 D 2012-07-25 2017-07-25 Common Stock 18271 18271 D Stock Option (Right to Buy) 7.34 2017-02-22 4 M 0 55360 0.00 D 2013-07-24 2018-07-24 Common Stock 55360 36907 D Represents shares acquired upon exercise of options by the Reporting Person, as reported in Table II. These shares are owned by LeMaitre Family LLC. A trust for the benefit of the Reporting Person holds a 20% membership interest in LeMaitre Family LLC. LeMaitre Family LLC is 100% owned by Peter Boland, as trustee for various trusts formed for the benefit of the children of George D. LeMaitre, the Issuer's founder, and Cornelia W. LeMaitre. LeMaitre Family LLC currently holds 460,154 shares of the Issuer's Common Stock. The Reporting Person disclaims ownership of such securities except to the extent of his pecuniary interest therein, if any, and the reporting herein of such securities shall not be construed as an admission of beneficial ownership thereof for the purposes of Section 16 or for any other purpose. This option is exercisable and vests over a five-year period at a rate of 20% on the first anniversary of the date listed in the table, and the balance vests in equal annual installments over the remaining four years, with the final vesting occurring on the 11th month after the fourth anniversary. /s/ Laurie A. Churchill, Attorney-in-fact 2017-02-24