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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
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 control number. | SEC 1474 (9-02) |
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 Underlying Securities (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) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Stock Options | $ 28.81 | 05/31/2013 | A | 1,167 | (8) | 05/31/2023 | Common Stock | 1,167 | $ 0 | 1,167 | D | ||||
Stock Options | $ 26.52 | 02/05/2014 | A | 2,000 | (8) | 02/05/2024 | Common Stock | 2,000 | $ 0 | 3,167 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
MILLS JEANNETTE M C/O MEDIFAST, INC. 3600 CRONDALL LANE OWINGS MILLS, MD 21117 |
Executive Vice President |
/s/ Jeannette M. Mills | 06/10/2014 | |
**Signature of Reporting Person | Date |
* | 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). |
(1) | These shares were granted to the reporting person under the 2012 Share Incentive Plan for satisfactory participation on the Board of Directors. These shares will vest in full on 1/1/2015. A portion of these shares were subsequently forfeited by the reporting person (see Footnote 3 below). |
(2) | These shares were granted to the reporting person under the 2012 Share Incentive Plan for satisfactory participation on the Board of Directors. These shares will vest in full on 2/5/2014. |
(3) | These shares represent a portion of the shares described in Footnote 1, which were forfeited by the reporting person in connection with her resignation from the Board of Directors. |
(4) | These shares were granted to the reporting person under the 2012 Share Incentive Plan as part of her employment agreement. These shares will vest annually in equal installments over a period of five years beginning on the first anniversary of the grant date. |
(5) | These shares were granted to the reporting person under the 2012 Share Incentive Plan for satisfactory participation on the Board of Directors prior to her resignation. These shares will vest in full on 2/5/2014. |
(6) | Represents shares issued upon the settlement of performance shares previously granted to the reporting person under the 2012 Share Incentive Plan for the fiscal 2013 performance period, which shares are fully vested. |
(7) | Represents the weighted average of multiple sales transactions ranging in price from $32.00 to $32.24. The reporting person agrees to provide upon request by the SEC Staff, the Issuer, or a security holder of the Issuer, full information regarding the number of shares sold at each separate price within the range. |
(8) | These retention stock options, which were issued to the reporting person under the 2012 Share Incentive Plan will vest annually in equal installments over a period of three years, beginning on the first anniversary of the grant date. |