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).
  
Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan for the purchase or sale of equity securities of the issuer that is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10.
1. Name and Address of Reporting Person*
LAMPROPOULOS FRED P

(Last) (First) (Middle)
1600 WEST 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)
PRESIDENT AND CEO
3. Date of Earliest Transaction (Month/Day/Year)
08/25/2023
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 08/25/2023 M 200,000 A $28.2 1,167,916 D
Common Stock, No Par Value 08/25/2023 M 6,000 A $28.2 12,888 I By spouse(1)
Common Stock, No Par Value 08/25/2023 F(2) 135,356 D $67.19 1,032,560 D
Common Stock, No Par Value 08/25/2023 F(3) 3,660 D $67.19 9,228 I By spouse(1)
Common Stock, No Par Value 97,083 I By 401(k) Plan
Common Stock, No Par Value 90 I By spouse as custodian for child(1)
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) $28.2 08/25/2023 M 200,000 04/14/2018(4) 04/14/2024 Common Stock 200,000 $0 0 D
Non-qualified stock options (right to buy) $28.2 08/25/2023 M 6,000 04/14/2018(5) 04/14/2024 Common Stock 6,000 $0 0 I By spouse(1)
Non-qualified stock options (right to buy) $44.8 03/02/2019(6) 03/02/2025 Common Stock 38,002 38,002 D
Non-qualified stock options (right to buy) $44.8 03/02/2019(7) 03/02/2025 Common Stock 4,000 4,000 I By spouse(1)
Non-qualified stock options (right to buy) $55.73 03/01/2020(8) 03/01/2026 Common Stock 159,151 159,151 D
Non-qualified stock options (right to buy) $55.73 03/01/2020(9) 03/01/2026 Common Stock 2,000 2,000 I By spouse(1)
Non-qualified stock options (right to buy) $37.71 02/26/2021(10) 02/26/2027 Common Stock 100,334 100,334 D
Non-qualified stock options (right to buy) $56.25 03/19/2022(11) 03/19/2028 Common Stock 58,083 58,083 D
Non-qualified stock options (right to buy) $70.58 02/28/2024(12) 02/28/2030 Common Stock 54,302 54,302 D
Explanation of Responses:
1. Represents securities held by the spouse of the Reporting Person. The Reporting Person expressly disclaims beneficial ownership of the securities owned by his spouse.
2. The Reporting Person surrendered 135,356 shares of common stock to the Issuer for payroll taxes and payment of the option price. No shares were sold in the open market.
3. The Reporting Person's spouse surrendered 3,660 shares of common stock to the Issuer for payroll taxes and payment of the option price. No shares were sold in the open market.
4. Becomes exercisable in equal annual installments of 20% commencing 4/14/2018.
5. Original grant of 10,000 options was to become vested and exercisable in equal annual installments of 20% commencing 4/14/2018. Options not vested as of 6/22/2020 have been forfeited.
6. Becomes exercisable in equal annual installments of 20% commencing 3/2/2019.
7. Original grant of 10,000 options was to become vested and exercisable in equal annual installments of 20% commencing 3/2/2019. Options not vested as of 6/22/2020 have been forfeited.
8. Becomes exercisable in equal annual installments of 20% commencing 3/1/2020.
9. Original grant of 10,000 options was to become vested and exercisable in equal annual installments of 20% commencing 3/1/2020. Options not vested as of 6/22/2020 have been forfeited.
10. Becomes exercisable in equal annual installments of 25% commencing 2/26/2021.
11. Becomes exercisable in equal annual installments of 25% commencing 3/19/2022.
12. Becomes exercisable in equal annual installments of 25% commencing 2/28/2024.
/s/ Brian G. Lloyd, Attorney-in-Fact 08/29/2023
** 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).
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