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MMSI Merit Medical Systems Inc

78.97
1.95 (2.53%)
After Hours
Last Updated: 21:06:30
Delayed by 15 minutes
Share Name Share Symbol Market Type
Merit Medical Systems Inc NASDAQ:MMSI NASDAQ Common Stock
  Price Change % Change Share Price Bid Price Offer Price High Price Low Price Open Price Shares Traded Last Trade
  1.95 2.53% 78.97 77.45 80.00 79.11 76.95 77.22 263,070 21:06:30

Annual Statement of Changes in Beneficial Ownership (5)

13/02/2020 8:49pm

Edgar (US Regulatory)


FORM 5
[ ] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
[ ] Form 3 Holdings Reported
[ ] Form 4 Transactions Reported UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES

                                                                                  
OMB APPROVAL
OMB Number: 3235-0362
Estimated average burden
hours per response...
1.0                       
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
                      

1. Name and Address of Reporting Person *

LIU DAVID MING-TEH
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
_____ Officer (give title below)    _____ Other (specify below)
(Last)          (First)          (Middle)

1600 WEST MERIT PARKWAY
3. Statement for Issuer's Fiscal Year Ended (MM/DD/YYYY)
12/31/2019 
(Street)

SOUTH JORDAN, UT 84095
(City)        (State)        (Zip)
4. If Amendment, Date Original Filed(MM/DD/YYYY)
 
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. Trans. Date2A. Deemed Execution Date, if any3. Trans. 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)
Amount(A) or (D)Price

Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivate Security
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security3. Trans. Date3A. Deemed Execution Date, if any4. Trans. 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
(MM/DD/YYYY)
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 at End of Issuer's Fiscal Year
(Instr. 4)
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 4)
11. Nature of Indirect Beneficial Ownership
(Instr. 4)
(A)(D)Date ExercisableExpiration DateTitleAmount or Number of Shares
Non-qualified stock options (right to buy) $21.71         7/25/2017 (1)7/25/2023 Common Stock 10500  10500 (2)D  
Non-qualified stock options (right to buy) $34.4         5/24/2018 (3)5/24/2024 Common Stock 12500  12500 (4)D  
Non-qualified stock options (right to buy) $50.5         6/7/2019 (5)6/7/2025 Common Stock 25000  25000 D  
Non-qualified stock options (right to buy) $52.17         5/24/2020 (6)5/24/2026 Common Stock 13750  13750 D  
Non-qualified stock options (right to buy) $52.17         5/31/2020 (7)5/31/2026 Common Stock 7500  7500 D  

Explanation of Responses:
(1) Becomes exercisable in equal annual installments of 20% commencing 07/25/2017.
(2) Since the date of the reporting person's last ownership report, the reporting person transferred one-half of this grant of stock options, equivalent to 10,500 shares, to his ex-wife pursuant to a domestic relations order. The reporting person disclaims beneficial ownership in all such transferred stock options and no longer reports them as beneficially owned.
(3) Becomes exercisable in equal annual installments of 20% commencing 05/24/2018.
(4) Since the date of the reporting person's last ownership report, the reporting person transferred one-half of this grant of stock options, equivalent to 12,500 shares, to his ex-wife pursuant to a domestic relations order. The reporting person disclaims beneficial ownership in all such transferred stock options and no longer reports them as beneficially owned.
(5) Becomes exercisable in equal annual installments of 20% commencing 06/07/2019.
(6) Becomes exercisable in equal annual installments of 33% commencing 05/24/2020.
(7) Becomes exercisable in equal annual installments of 33% commencing 05/31/2020.

Reporting Owners
Reporting Owner Name / Address
Relationships
Director10% OwnerOfficerOther
LIU DAVID MING-TEH
1600 WEST MERIT PARKWAY
SOUTH JORDAN, UT 84095
X



Signatures
Brian G. Lloyd, Attorney-in-Fact2/13/2020
**Signature of Reporting PersonDate

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