Initial Statement of Beneficial Ownership (3)
July 01 2021 - 6:16PM
Edgar (US Regulatory)
FORM 3
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
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3235-0104
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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
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Kirk Jennifer M |
2. Date of Event Requiring Statement (MM/DD/YYYY)
6/30/2021
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3. Issuer Name and Ticker or Trading Symbol
Medtronic plc [MDT]
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(Last)
(First)
(Middle)
710 MEDTRONIC PARKWAY LC300 |
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
_____ Director _____ 10% Owner
___X___ Officer (give title below) _____ Other (specify below)
Chief Accounting Officer / |
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(Street)
MINNEAPOLIS, MN 55432
(City)
(State)
(Zip)
| 5. If Amendment, Date Original Filed(MM/DD/YYYY)
| 6. 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 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 | 7104 | D | |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
(Instr. 4) | 2. Date Exercisable and Expiration Date
(MM/DD/YYYY) | 3. Title and Amount of Securities Underlying Derivative Security
(Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form of Derivative Security: 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 | (1) | (1) | Performance Share Units | 3373 (2) | (3) | D | |
| Stock Option (Right to Buy) | 2/1/2022 (4) | 2/1/2031 | Ordinary Shares | 11123 | $111.18 | D | |
| Explanation of Responses: |
| (1) | Vests on August 3, 2023. |
| (2) | 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, 3,373 shares will be issued. The actual number of shares to be issued could range from a low of 675 at minimum performance to a high of 6,746 shares at maximum performance. If minimum performance metrics are not met, such PSUs may vest at 0 shares. |
| (3) | Each performance share unit represents a contingent right to receive one share of Medtronic common stock. |
| (4) | These options become exercisable at the rate of 25% of the shares granted per year beginning on the first anniversary of grant. |
Reporting Owners
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| Reporting Owner Name / Address | Relationships |
| Director | 10% Owner | Officer | Other |
Kirk Jennifer M
710 MEDTRONIC PARKWAY LC300
MINNEAPOLIS, MN 55432 |
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| Chief Accounting Officer |
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Signatures
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| /s/ Thomas L. Osteraas, attorney-in-fact | | 7/1/2021 |
| **Signature of Reporting Person | Date |
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