Statement of Changes in Beneficial Ownership (4)
August 04 2021 - 6:26PM
Edgar (US Regulatory)
FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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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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Surface Carol A |
2. Issuer Name and Ticker or Trading Symbol
Medtronic plc
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MDT
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner
__X__ Officer (give title below) _____ Other (specify below)
SVP, Chief HR Officer |
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(Last)
(First)
(Middle)
710 MEDTRONIC PKWY MS LC300 |
3. Date of Earliest Transaction
(MM/DD/YYYY)
8/2/2021 |
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(Street)
MINNEAPOLIS, MN 55432
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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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 Acquired, Disposed of, or Beneficially Owned
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1.Title of Security
(Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code
(Instr. 8)
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4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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| Ordinary Shares | 8/2/2021 | | F | | 3997 | D | $131.31 | 30670 (1) | D | |
| Ordinary Shares | 8/2/2021 | | A(2) | | 3657 | A | $0 | 34327 | D | |
| Ordinary Shares | | | | | | | | 567 (3) | I | NQ Ret Plan Sup |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
(Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any | 4. Trans. 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 | 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 of Derivative Security: 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 Option (Right to Buy) | $131.26 | 8/2/2021 | | A | | 31245 | | 8/2/2022 (4) | 8/2/2031 | Ordinary Shares | 31245 | $0 | 31245 | D | |
| Stock Option (Right to Buy) | $131.26 | 8/2/2021 | | A | | 1085 | | 8/2/2022 (4) | 8/2/2031 | Ordinary Shares | 1085 | $0 | 1085 | D | |
| Performance Share Units | (5) | 8/2/2021 | | A | | 9143 (6) | | (7) | (7) | Performance Share Units | 9143 | $0 | 9143 | D | |
| Explanation of Responses: |
| (1) | This balance increased by 517 shares due to exempt transactions such as dividend reinvestment and employee stock purchase plan. |
| (2) | The restrictions on the award shall lapse 100% on the third anniversary of the Grant Date. |
| (3) | Between December 28, 2020 and June 30, 2021, the reporting person acquired 8 shares of MDT common stock under the Medtronic NQ Retirement Plan. The information in this report is based on a statement dated as of June 30, 2021. |
| (4) | These options become exercisable at the rate of 25% of the shares granted per year beginning on the first anniversary of grant. |
| (5) | Each performance share unit represents a contingent right to receive one share of Medtronic common stock. |
| (6) | 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, 9,143 shares will be issued. The actual number of shares to be issued could range from a low of 1,829 at minimum performance to a high of 18,286 shares at maximum performance. If minimum performance metrics are not met, such PSUs may vest at 0 shares. |
| (7) | Vests on August 2, 2024. |
Reporting Owners
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| Reporting Owner Name / Address | Relationships |
| Director | 10% Owner | Officer | Other |
Surface Carol A
710 MEDTRONIC PKWY MS LC300
MINNEAPOLIS, MN 55432 |
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| SVP, Chief HR Officer |
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Signatures
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| /s/ Thomas L. Osteraas, attorney-in-fact | | 8/4/2021 |
| **Signature of Reporting Person | Date |
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