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U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 4
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934,
Section 17(a) of the Public Utility Holding Company Act of 1935 or
Section 30(f) of the Investment Company Act of 1940
[ ] Check box if no longer subject to Section 16. Form 4 or Form 5 obligations
may continue. See Instruction 1(b).
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1. Name and Address of Reporting Person*
Weintraub B. Leigh
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(Last) (First) (Middle)
1600 West Merit Parkway
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(Street)
South Jordan UT 84095
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(City) (State) (Zip)
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2. Issuer Name and Ticker or Trading Symbol
Merit Medical Systems, Inc. MMSI
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3. IRS Identification Number of Reporting Person, if an Entity (Voluntary)
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4. Statement for Month/Year
September 2002
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5. If Amendment, Date of Original (Month/Year)
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6. Relationship of Reporting Person to Issuer
(Check all applicable)
[ ] Director [ ] 10% Owner
[X] Officer (give title below) [ ] Other (specify below)
Vice President-Operations
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7. Individual or Joint/Group Filing
(Check applicable line)
[X] Form filed by one Reporting Person
[ ] Form filed by more than one Reporting Person
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Table I -- Non-Derivative Securities Acquired, Disposed of,
or Beneficially Owned
6. Owner-
ship
5. Amount of Form: 7. Nature of
Securities Direct Indirect
1. Title of 2. Transaction 3. Transaction 4. Securities Acquired (A) Beneficially (D)or Beneficial
Security Date Code or Disposed of (D) Owned at End Indirect (I) Ownership
(Instr. 3) T(mm/dd/yy) (Instr. 8) (Instr. 3, 4 and 5) (Instr. 3 and 4) (Instr.4) (Instr.4)
Code V Amount (A)or(D) Price
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COMMON STOCK
NO PAR VALUE 09/18/02 M 3,125 A $ 3.72
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COMMON STOCK
NO PAR VALUE 09/18/02 3,125 D $18,25
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COMMON STOCK
NO PAR VALUE 1,305
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COMMON STOCK By Employee
NO PAR VALUE 2,568 D stock purchase
(2)
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COMMON STOCK By 401 (k)
NO PAR VALUE 3,500 plan (1)
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* If the form is filed by more than one Reporting Person, see Instruction
4(b)(v).
Reminder: Report on a separate line for each class of securities beneficially
owned directly or indirectly.
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FORM 4 (continued)
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Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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9. 10.
Number Owner-
of ship
2. Deriv- of
Conver- 5. 7. ative Deriv- 11.
sion Number of Title and Amount Secur- ative Nature
or Derivative 6. of Underlying 8. ities Secur- of
Exer- Securities Date Securities Price Bene- ity: In-
cise 3. Acquired (A) Exercisable and (Instr. 3 and 4) of ficially Direct direct
Price Trans- 4. or Disposed Expiration Date Deriv- Owned (D) or Bene-
1. of action Trans- of (D) (Month/Day/Year) Amount ative at End In- ficial
Title of Deriv- Date action (Instr. 3, or Secur- of direct Owner
Derivative ative (Month/ Code 4 and 5) Date Expira- Number ity Year (I) -ship
Security Secur- Day/ (Instr.8) Exer- tion of (Instr.(Instr. (Instr. (Instr.
(Instr. 3) ity Year) Code V (A) (D) cisable Date Title Shares 5) 4) 4) 4)
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Non-qualified $13.5280 N/A l2/08/02 12/08/11 Common 25,000 D
stock-option (3) Stock
(Right to buy)
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Non-qualified $3.68 N/A 02/12/02 12/12/11 Common 28,455 D
stock-option (7) Stock
(Right to buy)
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Non-qualified $4.1997 N/A 04/23/00 10/23/04 Common 5,470 D
stock-option (6) Stock
(Right to buy)
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Non-qualified $3.68 N/A 09/30/99 03/31/04 Common 6,250 D
stock-option (5) Stock
(Right to buy)
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Non-qualified $3.72 N/A M 3,125 06/18/98 02/18/02 Common 0 D
stock-option (4) Stock
(Right to buy)
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/s/ B. Leigh Weintraub September 19, 2002
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**Signature of Reporting Person Date
Explanation of Responses:
1. Represent plan holdings as of 12/21/01 based upon most recent plan statement
timely distributed
2. Purchase of 2,054 Shares from the Employee Stock Puchase Plan
3. Become exercisable in equal annual installments of 20% commencing 12/08/02
4. Become exersisable in equal annual installments of 20% commencing 06/18/98
5. Become exercisable in equal annual installments of 20% commencing 09/30/99
6. Become exercisable in equal annual installments of 20% commencing 04/23/00
7. Become exercisable in equal annual installments of 20% commencing 02/12/02
** 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 provided is insufficient, see Instruction 6 for procedure.
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