SEC FORM 4/A 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
 
OMB APPROVAL
OMB Number: 3235-0287
Estimated average burden
hours per response: 0.5
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*
LeMaitre George W

(Last) (First) (Middle)
C/O LEMAITRE VASCULAR, INC.
63 SECOND AVENUE

(Street)
BURLINGTON MA 01803

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
LEMAITRE VASCULAR INC [ LMAT ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director X 10% Owner
X Officer (give title below) Other (specify below)
Chairman and CEO
3. Date of Earliest Transaction (Month/Day/Year)
12/19/2020
4. If Amendment, Date of Original Filed (Month/Day/Year)
12/23/2020
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
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 12/19/2020 M 36(1) A $0(1) 2,784,717 D
Common Stock 12/19/2020 F 652(2) D $37.94 2,784,065 D
Common Stock 12/20/2020 M 13(1) A $0(1) 2,784,078 D
Common Stock 12/20/2020 F 460(3) D $37.94 2,783,618 D
Common Stock 12/22/2020 M 33(1) A $0(1) 2,783,651 D
Common Stock 12/22/2020 F 529(4) D $37.38 2,783,122 D
Common Stock 10,000 I See footnote(5)
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
Dividend Equivalent Rights (6) 12/19/2020 M 36(6) (6) (6) Common Stock 36 $0 113 D
Dividend Equivalent Rights (7) 12/20/2020 M 13(7) (7) (7) Common Stock 13 $0 53 D
Dividend Equivalent Rights (8) 12/22/2020 M 33(8) (8) (8) Common Stock 33 $0 65 D
Explanation of Responses:
1. Represents shares acquired upon release of dividend equivalent rights, as reported in Table II, on a one-for-one basis.
2. These shares represent shares withheld by the Issuer to satisfy tax withholding obligations incurred upon the vesting of restricted stock units awarded to the reporting person on December 19, 2018. This transaction is considered an exempt sale pursuant to Rule 16b-3(e) promulgated under the Securities Exchange Act of 1934.
3. These shares represent shares withheld by the Issuer to satisfy tax withholding obligations incurred upon the vesting of restricted stock units awarded to the reporting person on December 20, 2019. This transaction is considered an exempt sale pursuant to Rule 16b-3(e) promulgated under the Securities Exchange Act of 1934.
4. These shares represent shares withheld by the Issuer to satisfy tax withholding obligations incurred upon the vesting of restricted stock units awarded to the reporting person on December 22, 2017. This transaction is considered an exempt sale pursuant to Rule 16b-3(e) promulgated under the Securities Exchange Act of 1934.
5. These shares are owned by LeMaitre Family LLC. A trust for the benefit of the Reporting Person holds a 20% membership interest in LeMaitre Family LLC. LeMaitre Family LLC is 100% owned by Christopher Lynch, as trustee for various trusts formed for the benefit of the children of George D. LeMaitre, the Issuer's founder, and Cornelia W. LeMaitre. LeMaitre Family LLC currently holds 50,000 shares of the Issuer's Common Stock. The Reporting Person disclaims ownership of such securities except to the extent of his pecuniary interest therein, if any, and the reporting herein of such securities shall not be construed as an admission of beneficial ownership thereof for the purposes of Section 16 or for any other purpose.
6. These dividend equivalent rights were released in connection with the vesting of a restricted stock unit award granted on December 19, 2018. Each dividend equivalent right is the economic equivalent of one share of the Issuer's common stock.
7. These dividend equivalent rights were released in connection with the vesting of a restricted stock unit award granted on December 20, 2019. Each dividend equivalent right is the economic equivalent of one share of the Issuer's common stock.
8. These dividend equivalent rights were released in connection with the vesting of a restricted stock unit award granted on December 22, 2017. Each dividend equivalent right is the economic equivalent of one share of the Issuer's common stock.
Remarks:
This amendment corrects errors made by the Issuer's stock plan administrator in 1) the number of shares acquired by the Reporting Person upon the release of dividend equivalent rights on 12/22/2020, 2) the number of shares withheld by the Issuer to satisfy tax withholding obligations incurred upon the vesting of restricted stock units on 12/22/2020 and 3) the number of dividend equivalent rights released in connection with the vesting of restricted stock units on 12/22/2020, all of which were previously reported on a Form 4.
/s/ Laurie A. Churchill, Attorney-in-fact 01/08/2021
** 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.