SEC Filing | Merit Medical Systems, Inc.

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SEC FORM 4 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^*

FERRAND BRIAN L

(Last)

(First)

(Middle)

MERIT MEDICAL SYSTEMS INC

1600 W. MERIT PARKWAY

(Street)

SOUTH JORDAN

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)

	Director	10% Owner
X	Officer (give title below)	Other (specify below)
Director of Sales

3. Date of Earliest Transaction (Month/Day/Year)
09/04/2003

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)
1. Title of Security (Instr. 3)	2. Transaction Date (Month/Day/Year)	2A. Deemed Execution Date, if any (Month/Day/Year)	Code	V	Amount	(A) or (D)	Price		6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	7. Nature of Indirect Beneficial Ownership (Instr. 4)
Common Stock, no par value	09/03/2003	09/03/2003	M		3,830	A	$2.76	3,830⁽⁷⁾	D
Common Stock, no par value	09/03/2003	09/03/2003	S		3,830	D	$21.7	0⁽⁷⁾	D
Common Stock, no par value	08/08/1988		M		15,174⁽⁷⁾	A	⁽¹⁾	15,174⁽⁷⁾	I	by 401(k) Plan⁽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)
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)	Code	V	(A)	(D)	Date Exercisable	Expiration Date	Title	Amount or Number of Shares	8. Price of Derivative Security (Instr. 5)		10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	11. Nature of Indirect Beneficial Ownership (Instr. 4)
Employee stock option (right to buy)	$2.76⁽⁷⁾	08/08/1988	08/08/1988	M		4,167⁽⁷⁾		09/30/1999⁽⁶⁾	09/30/2004	Common Stock	4,167⁽⁷⁾	$2.76	4,167⁽⁷⁾	D
Employee stock option (right to buy)	$2.76⁽⁷⁾	09/03/2003	09/03/2003	M		3,830⁽⁷⁾		02/12/2002⁽²⁾	02/12/2011	Common Stock	3,830⁽⁷⁾	$2.76⁽⁷⁾	18,751⁽⁷⁾	D
Employee stock option (right to buy)	$10.15⁽⁷⁾	08/08/1988	08/08/1988	M		25,000⁽⁷⁾		12/08/2002⁽³⁾	12/08/2011	Common Stock	25,000⁽⁷⁾	$10.15⁽⁷⁾	25,000⁽⁷⁾	D
Employee stock option (right to buy)	$12.74⁽⁷⁾	08/08/1988	08/08/1988	M		13,333⁽⁷⁾		05/23/2003⁽⁴⁾	05/23/2012	Common Stock	13,333⁽⁷⁾	$12.74⁽⁷⁾	13,333⁽⁷⁾	D
Employee stock option (right to buy)	$12.99⁽⁷⁾	08/08/1988	08/08/1988	M		26,667⁽⁷⁾		02/06/2004⁽⁵⁾	02/06/2013	Common Stock	26,667⁽⁷⁾	$12.99⁽⁷⁾	26,667⁽⁷⁾	D

Explanation of Responses:

1. Represents plan holdings as of 09/04/03 per most recent plan statement timely distributed

2. Become exercisable in equal annual installments of 20% commencing 02/12/02

3. Become exercisable in equal annual installments of 20% commencing 12/08/02

4. Become exercisable in equal annual installments of 20% commencing 05/23/03

5. Become exercisable in equal annual installments of 20% commencing 02/06/04

6. Become exercisable in equal annual installments of 20% commencing 09/30/99

7. End of month number reflects forward split (4 for 3) effective 8/15/03.

	B. Leigh Weintraub by Kent W. Stanger, Atty-in-Fact per Pwr of Atty dtd 08/10/92 on file w/the Commission and incorporated here	09/05/2003
	** 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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