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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 | ||||||||
Restricted Deferred Stock Units | (1) | 12/31/2011 | M | 333,333 | (3) | (3) | Common Stock | 333,333 | $ 0 | 0 (4) | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
ELLIOTT JOHN RAYMOND ONE BOSTON SCIENTIFIC PLACE NATICK, MA 01760-1537 |
X |
/s/ Theresa R. Boni, Attorney-in-Fact | 01/04/2012 | |
**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) | Each deferred stock unit represents the Company's commitment to issue one share of Boston Scientific common stock. |
(2) | The Company's closing stock price on December 30, 2011. |
(3) | One third of the shares vested on June 23, 2010, the first anniversary of the award, and thereafter 1/36th of the shares vest on each subsequent monthly anniversary until the award is fully vested on the third anniversary of the award provided the reporting person is still an employee of the Company. Vested shares of common stock will be issued and income tax withholding amounts will be assessed to the reporting person on December 31 of the year shares vest. |
(4) | The remaining 166,667 restricted deferred stock units forfeited as of December 31, 2011 in connection with the reporting person's retirement from the Company. |
Remarks: Exhibit 24.1 Power of Attorney |