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)
Executive Chairman
3. Date of Earliest Transaction (Month/Day/Year)
09/24/2018
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 09/24/2018 S(1) 605,871 D $54.0126(2) 0 D
Class A Common Stock 09/24/2018 C 298,647 A $0.00(3) 298,647 I By David C. Paul Children's Trust(4)
Class A Common Stock 09/24/2018 S(1) 298,647 D $54.0126(2) 0 I By David C. Paul Children's Trust(4)
Class A Common Stock 09/24/2018 C 298,647 A $0.00(3) 298,647 I By Sonali Paul Children's Trust(5)
Class A Common Stock 09/24/2018 S(1) 298,647 D $54.0126(2) 0 I By Sonali Paul Children's Trust(5)
Class A Common Stock 09/24/2018 C 101,320 A $0.00(3) 101,320 D
Class A Common Stock 09/24/2018 S(1) 101,320 D $54.0126(2) 0 D
Class A Common Stock 09/25/2018 C 748,845 A $0.00(3) 748,845 D
Class A Common Stock 09/25/2018 S(1) 748,845 D $54.6964(6) 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(7) (3) 09/24/2018 C 298,647(3) (3) (3) Class A Common Stock 298,647 $0.00 0 I By David C. Paul Children's Trust(4)
Class B Common Stock(7) (3) 09/24/2018 C 298,647(3) (3) (3) Class A Common Stock 298,647 $0.00 0 I By Sonali Paul Children's Trust(5)
Class B Common Stock(7) (3) 09/24/2018 C 101,320(3) (3) (3) Class A Common Stock 101,320 $0.00 21,616,369 D
Class B Common Stock(7) (3) 09/25/2018 C 748,845(3) (3) (3) Class A Common Stock 748,845 $0.00 20,867,524 D
Class B Common Stock(7) (7) (7) (7) Class A Common Stock 1,562,573 1,562,573 I By Paul Family Irrevocable Trust U/A 4/6/10(8)
Explanation of Responses:
1. This sale was effected pursuant to a Rule 10b5-1 trading plan executed by the reporting person.
2. The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $54.00 to $54.26, inclusive. The reporting person undertakes to provide the Issuer, any security holder of the Issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the ranges set forth in footnote (2) to this Form 4.
3. The Company's Class B Common Stock converted into the Company's Class A Common Stock on a one-for-one basis at the election of the reporting person and has no expiration date.
4. These shares are held in a trust for the benefit of a child of the reporting person. The reporting person disclaims beneficial ownership of these securities, and the filing of this report is not an admission that the reporting person is the beneficial owner of these securities for purposes of Section 16 or for any other purpose.
5. These shares are held in a trust for the benefit of a child of the reporting person. The reporting person is trustee of the trust.
6. The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $54.00 to $55.00, inclusive. The reporting person undertakes to provide the Issuer, any security holder of the Issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the ranges set forth in footnote (6) to this Form 4.
7. 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.
8. These shares are held in a trust for the benefit of the reporting person's spouse and children. The reporting person's spouse is trustee of the trust.
Remarks:
/s/ Eric I. Schwartz, Attorney-in-Fact 09/26/2018
** 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).
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