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 |
| |||||||||||||||
| 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 ST JUDE MEDICAL INC [ STJ ] | 5. Relationship of Reporting Person(s) to Issuer (Check all applicable)
| ||||||||||||||||||||||||
3. Date of Earliest Transaction (Month/Day/Year) 12/15/2012 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed (Month/Day/Year) | 6. Individual or Joint/Group Filing (Check Applicable Line)
|
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) | |||
Code | V | Amount | (A) or (D) | Price | ||||||
Common Stock | 12/15/2012 | M | 50,000 | A | $30.58 | 50,000 | I(1) | Family Trust | ||
Common Stock | 12/15/2012 | F | 30,382(2) | D | $79.88 | 19,618 | I(1) | Family Trust | ||
Common Stock | 31,822(3) | D |
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) | ||||
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Stock Options (Right to Buy) | $30.58 | 10/18/2016 | G | V | 50,000 | 12/15/2009(4) | 12/15/2016 | Common Stock | 50,000 | $0 | 0 | D | |||
Stock Options (Right to Buy) | $30.58 | 10/18/2016 | G | V | 50,000 | 12/15/2009(4) | 12/15/2016 | Common Stock | 50,000 | $0 | 50,000 | I(1) | Family Trust | ||
Stock Options (Right to Buy) | $30.58 | 12/15/2016 | M | 50,000 | 12/15/2009(4) | 12/15/2016 | Common Stock | 50,000 | $0 | 0 | I(1) | Family Trust | |||
Stock Options (Right to Buy) | $30.59 | 10/18/2016 | G | V | 182,000 | 12/14/2010(4) | 12/14/2017 | Common Stock | 182,000 | $0 | 0 | D | |||
Stock Options (Right to Buy) | $30.59 | 10/18/2016 | G | V | 182,000 | 12/14/2010(4) | 12/14/2017 | Common Stock | 182,000 | $0 | 182,000 | I(1) | Family Trust | ||
Stock Options (Right to Buy) | $41.65 | 10/18/2016 | G | V | 204,000 | 12/14/2011(4) | 12/14/2018 | Common Stock | 204,000 | $0 | 0 | D | |||
Stock Options (Right to Buy) | $41.65 | 10/18/2016 | G | V | 204,000 | 12/14/2011(4) | 12/14/2017 | Common Stock | 204,000 | $0 | 204,000 | I(1) | Family Trust | ||
Stock Options (Right to Buy) | $34.96 | 10/18/2016 | G | V | 300,000 | 12/17/2012(4) | 12/12/2019 | Common Stock | 300,000 | $0 | 0 | D | |||
Stock Options (Right to Buy) | $34.96 | 10/18/2016 | G | V | 300,000 | 12/17/2012(4) | 12/12/2019 | Common Stock | 300,000 | $0 | 300,000 | I(1) | Family Trust | ||
Stock Options (Right to Buy) | $35.27 | 10/18/2016 | G | V | 183,750 | 12/17/2013(5) | 12/10/2020 | Common Stock | 245,000 | $0 | 61,250 | D | |||
Stock Options (Right to Buy) | $35.27 | 10/18/2016 | G | V | 183,750 | 12/17/2013(5) | 12/10/2020 | Common Stock | 183,750 | $0 | 183,750 | I(1) | Family Trust | ||
Stock Options (Right to Buy) | $59.41 | 10/18/2016 | G | V | 74,570 | 12/17/2014(5) | 12/10/2021 | Common Stock | 149,140 | $0 | 74,570 | D | |||
Stock Options (Right to Buy) | $59.41 | 10/18/2016 | G | V | 74,570 | 12/17/2014(5) | 12/10/2021 | Common Stock | 74,570 | $0 | 74,570 | I(1) | Family Trust | ||
Stock Options (Right to Buy) | $69.08 | 10/18/2016 | G | V | 36,148 | 12/17/2015(5) | 12/08/2022 | Common Stock | 144,592 | $0 | 108,444 | D | |||
Stock Options (Right to Buy) | $69.08 | 10/18/2016 | G | V | 36,148 | 12/17/2015(5) | 12/08/2022 | Common Stock | 36,148 | $0 | 36,148 | I(1) | Family Trust |
Explanation of Responses: |
1. The reporting person disclaims beneficial ownership of these securities, and this report shall not be deemed an admission that the reporting person is the beneficial owner of the securities for purposes of Section 16 or for any other purpose. |
2. Shares of common stock withheld to pay the exercise price of the stock options and to pay tax withholdings. The 50,000 shares acquired upon the option exercise, net of 30,382 shares used to pay exercise price and taxes, resulted in 19,618 shares that were retained. |
3. Includes 338 additional shares acquired through the Company Employee Stock Purchase Plan on 7/29/16. |
4. Fully vested at the time of filing. |
5. The option shares vest 25% on each of the first four anniversary dates of the date of the grant beginning on the date shown. |
/s/ Kashif Rashid, Attorney in Fact | 12/19/2016 | |
** 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. |