5 1 williamgeorgefy02form5.txt WILLIAM GEORGE FY02 FORM 5 1. Name and Address of Reporting Person George, William W. Medtronic, Inc. 710 Medtronic Pkwy Minneapolis, MN 55432- 2. Issuer Name and Ticker or Trading Symbol Medtronic, Inc. (MDT) 3. IRS or Social Security Number of Reporting Person (Voluntary) 4. Statement for Month/Year 2002 5. If Amendment, Date of Original (Month/Day/Year) 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) ( ) Director ( ) 10% Owner ( ) Officer (give title below) (X) Other (specify below) Retired Chairman of the Board (as of 4/26/02) 7. Individual or Joint/Group Filing (Check Applicable Line) (X) Form filed by One Reporting Person ( ) Form filed by More than One Reporting Person TABLE I -- Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
+---------------------------------+----------+-------------+-----------------------------+----------------+-----------+------------+ |1. Title of Security |2. Trans- |3. Trans- |4. Securities Acquired (A) |5. Amount of |6. Owner- |7. Nature | | | action | action | or Disposed of (D) | Securities | ship | of In- | | | Date | Code | | Beneficially | Form: | direct | | | | | | Owned at | Direct | Bene- | | | (Month/ | | | End of | (D) or | ficial | | | Day/ | +-----------+------+----------+ Year | Indirect| Owner- | | | Year) | |Amount |A/D |Price | | (I) | ship | +---------------------------------+----------+-------------+-----------+------+----------+----------------+-----------+------------+ Common Stock 1307217.957 D Common Stock 9157.216 I By ESOP Common Stock 10600 I By Trust fbo Son Common Stock 1400 I By Spouse Common Stock 7000 I By Trust fbo Son
TABLE II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned
+-------------+--------+----------+---------+-----------+---------------------+----------------+----------+--------+-------+-------+ |1. |2. |3. |4. |5. |6. |7. |8. |9. |10. |11. | | | | | | | | | |Number |Owner- | | | | | | | | | | |of |ship | | | | | | | | | | |Deriv- |Form of| | | | | | | | |Title and Amount| |ative |Deriv- | | | | | | | | |of Underlying | |Secur- |ative |Nature | | |Conver- | | |Number of | |Securities | |ities |Secur- |of | | |sion or | | |Derivative |Date Exercisable +-------+--------+ |Benefi- |ity: |In- | | |Exercise| | |Securities |and Expiration Date | |Amount | |cially |Direct |direct | | |Price of|Transac- |Transac- |Acquired(A)|(Month/Day/Year) | |or | |Owned |(D) or |Bene- | |Title of |Deriv- |tion Date |tion Code|Disposed(D)+----------+----------+ |Number |Price of |at End |In- |ficial | |Derivative |ative |(Month/ | +-----+-----+Date Exer-|Expira- | |of |Derivative|of |direct |Owner- | |Security |Security|Day/Year) | |(A) |(D) |cisable |tion Date |Title |Shares |Security |Year |(I) |ship | +-------------+--------+----------+---------+-----+-----+----------+----------+-------+--------+----------+--------+-------+-------+ Stock Options $43.81 04/26/2002 A 31847 04/26/2002 04/26/2012 Common 31847 $0.0000 31847 D (Right to buy) Stock Right to $0 04/26/2002 A 837.0 Common 837.028 $0.0000 D Receive Stock 28 Stock Right to $0 04/26/2002 A 1522. Common 1522.329 $0.0000 2359.35 D Receive Stock 329 Stock 7 Explanation of Responses: Rights acquired under the Medtronic, Inc. Executive Non-qualified Supplemental Benefit Plan to be settled in Medtronic common stock as a 1-for-1 conversion upon the employee's retirement or other termination of employment. Dividend equivalents on deferred units to be paid out at the director or officer's retirement or termination of employment.
SIGNATURE OF REPORTING PERSON /s/ William W. George DATE 06/07/2002