SEC FORM 4 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
 
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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*
Paul David C

(Last) (First) (Middle)
VALLEY FORGE BUSINESS CENTER
2560 GENERAL ARMISTEAD AVENUE

(Street)
AUDUBON PA 19403

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
GLOBUS MEDICAL INC [ GMED ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director X 10% Owner
X Officer (give title below) Other (specify below)
Chief Executive Officer
3. Date of Earliest Transaction (Month/Day/Year)
08/08/2012
4. If Amendment, Date of Original Filed (Month/Day/Year)
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
Class A Common Stock 08/08/2012 C 3,039,385 A $0.00(1) 3,039,385 D
Class A Common Stock 08/08/2012 S 3,039,385 D $11.16 0 D
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
Class B Common Stock(2) (1) 08/08/2012 C 3,039,385 (1) (1) Class A Common Stock 3,039,385 $0.00 24,993,920 D
Stock Option (Right to Buy Class A Common Stock)(3) $4.88 08/08/2012 J(3) V 18,461 (4) 08/06/2019 Class A Common Stock(3) 18,461 $0.00 18,461 D
Stock Option (Right to Buy Class A Common Stock)(3) $11.87 08/08/2012 J(3) V 18,461 (5) 06/16/2020 Class A Common Stock(3) 18,461 $0.00 18,461 D
Stock Option (Right to Buy Class A Common Stock(3) $10.66 08/08/2012 J(3) V 18,461 (6) 10/27/2021 Class A Common Stock(3) 18,461 $0.00 18,461 D
Class B Common Stock(2) (2) (2) (2) Class A Common Stock 2,383,636 2,383,636 I By David C. Paul 2010 Grantor Retained Annuity Trust U/A 4/6/10
Explanation of Responses:
1. The Company's Class B Common Stock automatically converted into the Company's Class A Common Stock on a one-for-one basis upon the sale of the shares and has no expiration date.
2. From the date of acquisition, the Company's Class B Common Stock converts into the Company's Class A Common Stock on a one-for-one basis (i) at the option of the holder, (ii) upon certain transfers, (iii) upon the closing of the Company's initial public offering if at that time the Company's Class B Common Stock that the holder beneficially owns is less than 10% of the aggregate number of all outstanding shares of the Company's common stock, and (iv) immediately if, at any time following the initial public offering of the Company's common stock, the Company's Class B Common Stock that the holder beneficially owns represents less than 5% of all outstanding shares of the Company's common stock.
3. Initially the stock option provided a right to buy the Company's Class C Common Stock. Upon the closing of the Company's initial public offering, all shares of the Company's Class C Common Stock automatically converted into shares of the Company's Class A Common Stock on a one-for-one basis. As a result, this stock option automatically converted into a right to buy the Company's Class A Common Stock.
4. These options were granted on August 6, 2009, and vest over a four-year period with one-fourth (1/4) of the options granted vesting on January 1, 2010, the first anniversary of the vesting commencement date, and the balance of the options granted vesting ratably on a monthly basis over the following 36 months.
5. These options were granted on June 16, 2010, and vest over a four-year period with one-fourth (1/4) of the options granted vesting on January 1, 2011, the first anniversary of the vesting commencement date, and the balance of the options granted vesting ratably on a monthly basis over the following 36 months.
6. These options were granted on October 27, 2011, and vest over a four-year period with one-fourth (1/4) of the options granted vesting on January 1, 2012, the first anniversary of the vesting commencement date, and the balance of the options granted vesting ratably on a monthly basis over the following 36 months.
Remarks:
/s/ David P. Creekman, Attorney-in-Fact 08/10/2012
** Signature of Reporting Person Date
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