Form Type: 4

SEC EDGAR Link
Accession Number:0001127602-21-021212
Date:2021-05-14
Issuer: INSULET CORP (PODD)
Original Submission Date:

Reporting Person:

PETROVIC SHACEY
C/O INSULET CORPORATION
100 NAGOG PARK ACTON, MA 01720

Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
Title of SecurityTransaction Date2a. Deemed Execution Date Transaction CodeSharesAcquired or DisposedPrice per share 5. Amount of Securities Beneficially Owned Following Reported Transaction 6. Ownership Form Direct or IndirectNature of Indirect Ownership
COMMON STOCK 2021-05-14 G 25,905 d $0.00 15,684 direct
COMMON STOCK 2021-05-14 G 25,905 a $0.00 25,905 indirect
COMMON STOCK 2021-07-01 M 15,000 a $30.58 30,779 direct
COMMON STOCK 2021-07-01 S 15,000 d $278.56 15,779 direct
COMMON STOCK 2021-05-14 0 $0.00 87,495 indirect
Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, convertible securities
Title of Derivative Security Conversion or Exercise Price of Derivative Security Transaction Date Deemed Execution Date Transaction Code Number of Derivative Securities Acquired (A) or Disposed of (D) Date ExercisableExpiration Date Title and Amount of Securities Underlying Derivative Security Price of Derivative Security Number of derivative Securities Beneficially Owned Following Reported Transaction(s) Ownership Form: Direct (D) or Indirect (I) Nature of Indirect Beneficial Ownership
EMPLOYEE STOCK OPTION (RIGHT TO BUY) 30.58 2021-07-01 deemed execution date M 15,000 (d) 2025-02-09 common stock 15,000 $30.58 7,436 direct
Footnotes
IDfootnote
f1 on may 14, 2021, the reporting person gifted 25,905 shares of insulet common stock to a family trust of which the reporting person is the settlor and a trustee. the beneficiaries of the trust are members of the reporting person's immediate family.
f2 the transactions reported in this form 4 were effected pursuant to an existing rule 10b5-1 trading plan.
f3 includes 95 shares acquired under the insulet corporation employee stock purchase plan on may 28, 2021.
f4 the price reported represents the weighted average sale price of the shares sold. the shares were sold at varying prices in the range of $274.695 to $280.55. the reporting person hereby undertakes, upon request of the staff of the u.s. securities 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.
f5 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.
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