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*
(Street)
| 2. Issuer Name and Ticker or Trading Symbol INSULET CORP [ PODD ] | 5. Relationship of Reporting Person(s) to Issuer (Check all applicable)
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| 3. Date of Earliest Transaction (Month/Day/Year) 07/01/2022 | ||||||||||||||||||||||||||
| 4. 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 Acquired, Disposed of, or Beneficially Owned | ||||||||||
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| 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 | 07/01/2022 | M | 7,070(1) | A | $29.26 | 20,765(2) | D | |||
| Common Stock | 07/01/2022 | M | 7,930(1) | A | $46.22 | 28,695 | D | |||
| Common Stock | 07/01/2022 | S | 15,000(1) | D | $222.9(3) | 13,695 | D | |||
| Common Stock | 61,259 | I | By NG Trust | |||||||
| Common Stock | 26,304 | I | By SP Trust | |||||||
| Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
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| 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 | ||||||||
| Employee Stock Option (Right to Buy) | $29.26 | 07/01/2022 | M | 7,070 | (4) | 02/24/2026 | Common Stock | 7,070 | $0 | 0 | D | ||||
| Employee Stock Option (Right to Buy) | $46.22 | 07/01/2022 | M | 7,930 | (4) | 02/22/2027 | Common Stock | 7,930 | $0 | 25,445 | D | ||||
| Explanation of Responses: |
| 1. The transactions reported in this Form 4 were effected pursuant to an existing Rule 10b5-1 trading plan. |
| 2. Includes 88 shares acquired under the Insulet Corporation Employee Stock Purchase Plan on May 31, 2022. |
| 3. The price reported represents the weighted average sale price of the shares sold. The shares were sold at varying prices in the range of $214.16 to $226.52. Specifically: 21 shares were sold in the range of $214.16 to $214.26 per share, with a weighted average share price of $214.26; 23 shares were sold at a price $215.19; 400 shares were sold in the range of $216.59 to $217.58 per share, with a weighted average share price of $217.09; 106 shares were sold in the range of $218.83 to $219.81 per share, with a weighted average share price of $218.89; 1,299 shares were sold in the range of $220.09 to $221.02 per share, with a weighted average share price of $220.47; 2,988 shares were sold in the range of $221.21 to $222.18 per share, with a weighted average share price of $221.68; 3,930 shares were sold in the range of $222.27 to $223.27 per share, with a weighted average share price of $222.81; 2,812 shares were sold in the range of $223.35 to $224.34 per share, with a weighted average share price of $223.75; 2,113 shares were sold in the range of $224.37 to $225.33 per share, with a weighted average share price of $224.71 and 1,308 shares were sold in the range of $225.57 to $226.52 per share, with a weighted average share price of $226.03. The Reporting Person hereby undertakes, upon request of the Staff of the U.S. Securities and Exchange Commission, the Issuer or a security holder of the Issuer, to provide full information regarding the number of shares sold at each separate price. |
| 4. This option is subject to a four-year vesting period with 25% of the total award vesting one year after the grant date and the remainder vesting in equal quarterly installments each quarter thereafter for 12 quarters, subject to continued employment. |
| /s/ John W. Kapples, attorney-in-fact | 07/06/2022 | |
| ** 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 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. | ||
| 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. | ||