SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
STANGER KENT W

(Last) (First) (Middle)
1600 W MERIT PARKWAY

(Street)
SOUTH JORDAN UT 84095

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
MERIT MEDICAL SYSTEMS INC [ MMSI ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
X Officer (give title below) Other (specify below)
Chief Financial Officer
3. Date of Earliest Transaction (Month/Day/Year)
03/16/2015
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. 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 (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock, No Par Value 80,885 I By 401(k) plan(1)
Common Stock, No Par Value 4,271(2) D
Common Stock, No Par Value 29,524 I Family Limited Liability Company(3)
Common Stock, No Par Value 03/16/2015 M 18,750 A $11.41 420,841 D
Common Stock, No Par Value 03/16/2015 M 43,750 A $11.53 464,591 D
Common Stock, No Par Value 03/16/2015 F 44,988(4) D $19.6 419,603 D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Non-qualified stock options (right to buy) $11.41 03/16/2015 M 18,750 05/25/2005 05/25/2015 Common Stock 18,750 $0 0 D
Non-qualified stock options (right to buy) $9.71 12/28/2005 12/28/2015 Common Stock 25,000 25,000 D
Non-qualified stock options (right to buy) $11.53 03/16/2015 M 43,750 05/21/2009(5) 05/21/2015 Common Stock 43,750 $0 0 D
Non-qualified stock options (right to buy) $13.82 09/26/2010(6) 09/26/2016 Common Stock 25,000 25,000 D
Non-qualified stock options (right to buy) $13.75 08/11/2012(7) 08/11/2018 Common Stock 80,000 80,000 D
Non-qualified stock options (right to buy) $12.06 10/04/2015(8) 10/04/2021 Common Stock 10,000 10,000 D
Non-qualified stock options (right to buy) $17.27 02/13/2016(9) 02/13/2022 Common Stock 21,800 21,800 D
Explanation of Responses:
1. Represents plan holdings as of 03/17/2015.
2. Employee stock purchase plan holdings as of 03/17/2015.
3. This report shall not be deemed an admission that the reporting person is the beneficial owner of the securities held by K.W.S. Properties LC.
4. Stock options were exercised in a swap transaction with the Company. 44,988 shares of common stock were surrendered for payroll taxes and payment of the option price. No shares were sold in the open market.
5. Becomes exercisable in equal annual installments of 20% commencing 05/21/2009.
6. Becomes exercisable in equal annual installments of 20% commencing 09/26/2010.
7. Becomes exercisable in equal annual installments of 20% commencing 08/11/2012.
8. Becomes exercisable in equal annual installments of 20% commencing 10/04/2015.
9. Becomes exercisable in equal annual installments of 20% commencing 02/13/2016.
Rashelle Perry, Attorney-in-Fact 03/18/2015
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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