SEC Form 3
FORM 3 | UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES 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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1. Name and Address of Reporting Person*
(Street)
| 2. Date of Event Requiring Statement (Month/Day/Year) 06/27/2022 | 3. Issuer Name and Ticker or Trading Symbol Medtronic plc [ MDT ] | |||||||||||||
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
| 5. If Amendment, Date of Original Filed (Month/Day/Year) | ||||||||||||||
6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Beneficially Owned | |||
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1. Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
Ordinary Shares | 28,905(1) | D |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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1. Title of Derivative Security (Instr. 4) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) | ||
Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Performance Share Units | (2) | (2) | Performance Share Units | 9,564(3) | (4) | D | |
Performance Share Units | (2) | (2) | Performance Share Units | 8,317(5) | (4) | D | |
Stock Option (Right to Buy) | 04/05/2022(6) | 04/05/2031 | Ordinary Shares | 30,837 | 120.25 | D | |
Stock Option (Right to Buy) | 08/02/2022(6) | 08/02/2031 | Ordinary Shares | 31,028 | 131.26 | D | |
Performance Share Units | (7) | (7) | Performance Share Units | 8,762(8) | (4) | D |
Explanation of Responses: |
1. Includes 18,695 restricted stock units that vest on 4/5/23, 3,910 restricted stock units that vest on 8/23/23 and 3,564 restricted stock units that vest on 8/2/24. |
2. Vests on August 3, 2023. |
3. The number of shares to be issued in connection with the performance share units ("PSUs") will vary depending on the level of certain performance metrics achieved over a three (3) year performance period. If target performance metrics are achieved, 9,564 shares will be issued. If minimum performance metrics are not met, such PSUs may vest at 0 shares. |
4. Each Performance Share Unit represents a contingent right to receive one share of Medtronic Common Stock. |
5. The number of shares to be issued in connection with the performance share units ("PSUs") will vary depending on the level of certain performance metrics achieved over a three (3) year performance period. If target performance metrics are achieved, 8,317 shares will be issued. If minimum performance metrics are not met, such PSUs may vest at 0 shares. |
6. These options become exercisable at the rate of 25% of the shares granted per year beginning on the first anniversary of grant. |
7. Vests on August 2, 2024. |
8. The number of shares to be issued in connection with the performance share units ("PSUs") will vary depending on the level of certain performance metrics achieved over a three (3) year performance period. If target performance metrics are achieved, 8,762 shares will be issued. If minimum performance metrics are not met, such PSUs may vest at 0 shares. |
/s/ Thomas L. Osteraas, attorney-in-fact | 07/07/2022 | |
** 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 5 (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. | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |