SEC Form 4
FORM 4 [ ] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). |
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, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(f) of the Investment Company Act of 1940 |
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1. Name and Address of Reporting Person* Ciffolillo, Joseph A. (Last) (First) (Middle) One Boston Scientific Place (Street) Natick, MA 01760-1537 (City) (State) (Zip) USA |
2. Issuer Name and Ticker or Trading Symbol Boston Scientific Corporation (BSX) 3. I.R.S. Identification Number of Reporting Person, if an entity (voluntary) |
4. Statement for (Month/Day/Year) January 17, 2003 5. If Amendment, Date of Original (Month/Year) |
6. Relationship of Reporting Person(s) to Issuer (Check all applicable) X Director 10% Owner Officer Other Officer/Other Description 7. Individual or Joint/Group Filing (Check Applicable Line) X Individual Filing Joint/Group Filing |
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned |
1. Title of Security (Instr. 3) |
2. Transaction Date (Month/Day/Year) |
3. Transaction Code | V |
4. Securities Acquired (A) or Disposed (D) Of Amount | A/D | Price |
5. Amount of Securities Beneficially Owned at End ofMonth (Instr. 3 and 4) |
6. Owner- ship Form: Direct(D) or Indirect (I) (Instr. 4) |
7. Nature of Indirect Beneficial Ownership (Instr. 4) |
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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). (over) SEC 1474 (3-99) |
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Ciffolillo, Joseph A. - January 2003 |
Form 4 (continued) |
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. Conver- sion or Exercise Price of Deri- vative Security |
3. Transaction Date (Month/ Day/ Year) |
4. Transaction Code and Voluntary (V) Code (Instr.8) Code | V |
5. Number of Derivative |
6. Date Exercisable(DE) and Expiration Date(ED) (Month/Day/Year) (DE) | (ED) |
7. Title and Amount of Underlying Securities (Instr. 3 and 4) |
8. Price of Derivative Security (Instr.5) |
9. Number of |
10. |
11. Nature of |
Forward Sale Contract |
$0.0000 |
1/17/03 |
J (1) | |
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Common Stock - 161,656 |
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D |
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Stock Option (Right to Buy) |
$28.3125 |
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Varies (2) | 05/09/2010 |
Common Stock - 4,000 |
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4,000 |
D |
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Stock Option (Right to Buy) NED |
$24.8125 |
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Varies (3) | 05/05/2007 |
Common Stock - 4,000 |
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4,000 |
D |
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Stock Option (Right to Buy) NED |
$36.6875 |
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Varies (4) | 05/05/2008 |
Common Stock - 4,000 |
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4,000 |
D |
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Stock Option (Right to Buy) NED |
$41.2500 |
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Varies (5) | 05/04/2009 |
Common Stock - 4,000 |
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4,000 |
D |
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Stock Option (Right to Buy) NED |
$15.5300 |
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Varies (6) | 05/08/2011 |
Common Stock - 2,000 |
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2,000 |
D |
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Stock Option (Right to Buy) NED |
$24.6800 |
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Varies (7) | 05/07/2012 |
Common Stock - 2,000 |
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2,000 |
D |
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Explanation of Responses :
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations. |
By: Lawrence J. Knopf, Attorney-in-fact ________________________________ 01-22-2003 ** Signature of Reporting Person Date Joseph A. Ciffolillo Page 2 SEC 1474 (3-99) |
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Ciffolillo, Joseph A. - January 2003 |
Form 4 (continued) |
FOOTNOTE Descriptions for Boston Scientific Corporation (BSX) Form 4 - January 2003 Joseph A. Ciffolillo One Boston Scientific Place Natick, MA 01760-1537 Explanation of responses: (1) Upon the settlement of a previously reported prepaid variable forward sale agreement entered into on November 26, 2001, the reporting person delivered 161,656 shares of Common Stock to the buyer on January 17, 2003 in accordance with the terms of the agreement. (2) Grant to the reporting person of an option to buy a specified number of shares of Common Stock exercisable 25% on May 9, 2001, 50% on May 9, 2002, 75% on May 9, 2003 and 100% on May 9, 2004, the anniversary date of the grant. (3) Grant to the reporting person of options to buy 4,000 shares of Common Stock exercisable in annual installments of 1,333 shares on May 5, 1998, 1,333 shares on May 5, 1999 and 1,334 shares on May 5, 2000. (4) Grant to the reporting person of options to buy 4,000 shares of Common Stock exercisable in annual installments of 1,333 shares on May 5, 1999, 1,333 shares on May 5, 2000 and 1,334 shares on May 5, 2001. (5) Grant to the reporting person of options to buy 4,000 shares of Common Stock exercisable in annual increments of 1,333 on May 4, 2000, 1,333 shares on May 4, 2001 and 1,334 shares on May 4, 2002, the anniversary date of the grant. (6) Grant to the reporting person of options to buy 2,000 shares of Common Stock exercisable in annual installments of 667, 667 and 666 shares each on May 8, 2002, 2003 and 2004, the anniversary date of the grant. (7) Grant to the reporting person of options to buy 2,000 shares of Common Stock exercisable in annual installments of 667, 667 and 666 shares each on May 7, 2003, 2004 and 2005, the anniversary date of the grant. |
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