0001571049-16-017110.txt : 20160804 0001571049-16-017110.hdr.sgml : 20160804 20160804160321 ACCESSION NUMBER: 0001571049-16-017110 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160802 FILED AS OF DATE: 20160804 DATE AS OF CHANGE: 20160804 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: TACTILE SYSTEMS TECHNOLOGY INC CENTRAL INDEX KEY: 0001027838 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE BUSINESS ADDRESS: STREET 1: 1331 TYLER STREET NE STE 200 CITY: MINNEAPOLIS STATE: MN ZIP: 55413 BUSINESS PHONE: 866-435-3948 MAIL ADDRESS: STREET 1: 1331 TYLER STREET NE STE 200 CITY: MINNEAPOLIS STATE: MN ZIP: 55413 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: LUBIN DANIEL C CENTRAL INDEX KEY: 0001335280 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37799 FILM NUMBER: 161807324 MAIL ADDRESS: STREET 1: RADIUS VENTURE PARTNERS II LLC STREET 2: 400 MADISON AVE 8TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10017 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Davis Jordan CENTRAL INDEX KEY: 0001328592 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37799 FILM NUMBER: 161807325 MAIL ADDRESS: STREET 1: C/O AMERICAN BANK NOTE HOLOGRAPHICS, INC STREET 2: 399 EXECUTIVE BOULEVARD CITY: ELMSFORD STATE: NY ZIP: 10523 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Radius Venture Partners III (OHIO), LP CENTRAL INDEX KEY: 0001654645 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37799 FILM NUMBER: 161807326 BUSINESS ADDRESS: STREET 1: 400 MADISON AVE. STREET 2: 8TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10017 BUSINESS PHONE: 6123555202 MAIL ADDRESS: STREET 1: 1331 TYLER STREET NE STREET 2: SUITE 200 CITY: MINNEAPOLIS STATE: MN ZIP: 55413 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: RADIUS VENTURE PARTNERS III L P CENTRAL INDEX KEY: 0001386468 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37799 FILM NUMBER: 161807328 BUSINESS ADDRESS: STREET 1: 400 MADISON AVE 8TH FL CITY: NEW YORK STATE: NY ZIP: 10017 BUSINESS PHONE: 212-897-7778 MAIL ADDRESS: STREET 1: 400 MADISON AVE 8TH FL CITY: NEW YORK STATE: NY ZIP: 10017 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Radius Venture Partners III, LLC CENTRAL INDEX KEY: 0001402970 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37799 FILM NUMBER: 161807329 BUSINESS ADDRESS: STREET 1: 400 MADISON AVENUE STREET 2: 8TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10017 BUSINESS PHONE: 212-897-7778 MAIL ADDRESS: STREET 1: 400 MADISON AVENUE STREET 2: 8TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10017 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Radius Venture Partners III QP, L.P. CENTRAL INDEX KEY: 0001402778 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37799 FILM NUMBER: 161807327 BUSINESS ADDRESS: STREET 1: 400 MADISON AVENUE STREET 2: 8TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10017 BUSINESS PHONE: 212-897-7778 MAIL ADDRESS: STREET 1: 400 MADISON AVENUE STREET 2: 8TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10017 4 1 t1601927_f4.xml OWNERSHIP DOCUMENT X0306 4 2016-08-02 0 0001027838 TACTILE SYSTEMS TECHNOLOGY INC TCMD 0001402970 Radius Venture Partners III, LLC 250 PARK AVENUE, SUITE 1102 NEW YORK NY 10177 0 0 1 0 0001386468 RADIUS VENTURE PARTNERS III L P 250 PARK AVENUE, SUITE 1102 NEW YORK NY 10177 0 0 1 0 0001402778 Radius Venture Partners III QP, L.P. 250 PARK AVENUE, SUITE 1102 NEW YORK NY 10177 0 0 1 0 0001654645 Radius Venture Partners III (OHIO), LP 250 PARK AVENUE, SUITE 1102 NEW YORK NY 10177 0 0 1 0 0001328592 Davis Jordan 250 PARK AVENUE, SUITE 1102 NEW YORK NY 10177 0 0 1 0 0001335280 LUBIN DANIEL C 250 PARK AVENUE, SUITE 1102 NEW YORK NY 10177 0 0 1 0 Common Stock 2016-08-02 4 C 0 150767 A 150767 I By Radius Venture Partners III, LP Common Stock 2016-08-02 4 C 0 1644046 A 1644046 I By Radius Venture Partners III QP, LP Common Stock 2016-08-02 4 C 0 206478 A 206478 I By Radius Venture Partners III (Ohio) LP Common Stock 5000 D Series B Preferred Stock 2016-08-02 4 C 0 87123 D Common Stock 87123 0 I By Radius Venture Partners III, LP Series B Preferred Stock 2016-08-02 4 C 0 950027 D Common Stock 950027 0 I By Radius Venture Partners III QP, LP Series B Preferred Stock 2016-08-02 4 C 0 119316 D Common Stock 119316 0 I By Radius Venture Partners III (Ohio) LP Each share of Series B Preferred Stock was convertible at any time at the option of the holder, and converted automatically into shares of the Issuer's Common Stock on a one-for one basis in connection with the closing of the Issuer's initial public offering. In addition, the holder was entitled to receive additional shares of common stock equal to the original purchase price per share ($3.8048) divided by the price to the public of the shares of common stock issued in the Issuer's initial public offering and these shares accrued a dividend that was payable-in-kind in shares of the Issuer's common stock. The securities did not have an expiration date. The securities converted automatically into shares of the Issuer's Common Stock on a one-for-one basis in connection with the closing of the Issuer's initial public offering. These securities are held directly by Radius Venture Partners III, L.P. and indirectly by Radius Venture Partners III, LLC, the general partner of Radius Venture Partners III, L.P., Jordan S. Davis, a director of Issuer, and managing member of Radius Venture Partners III, LLC and Daniel C. Lubin, managing member of Radius Venture Partners III, LLC. Each of Radius Venture Partners III, LLC, Mr. Davis and Mr. Lubin may be deemed to beneficially own such securities, and disclaims such beneficial ownership except to the extent of its or his pecuniary interest therein. These securities are held directly by Radius Venture Partners III QP, L.P. and indirectly by Radius Venture Partners III, LLC, the general partner of Radius Venture Partners III QP, L.P., Jordan S. Davis, a director of Issuer and managing member of Radius Venture Partners III, LLC, and Daniel C. Lubin, managing member of Radius Venture Partners III, LLC. Each of Radius Venture Partners III, LLC, Mr. Davis and Mr. Lubin may be deemed to beneficially own such securities, and disclaims such beneficial ownership except to the extent of its or his pecuniary interest therein. These securities are held directly by Radius Venture Partners III (Ohio), L.P. and indirectly by Radius Venture Partners III, LLC, the general partner of Radius Venture Partners III (Ohio), L.P., Jordan S. Davis, a director of Issuer, and managing member of Radius Venture Partners III, LLC and Daniel C. Lubin, managing member of Radius Venture Partners III, LLC. Each of Radius Venture Partners III, LLC, Mr. Davis and Mr. Lubin may be deemed to beneficially own such securities, and disclaims such beneficial ownership except to the extent of its or his pecuniary interest therein. Represents 5,000 restricted stock units granted to Jordan Davis, a director of Issuer, subject to vesting in full on the earlier of (a) July 27, 2017 or (b) immediately prior to the next annual meeting of stockholders following July 27, 2016, subject to his continued service as a director as of such date. The restricted stock units may only be settled in shares of common stock on a one-for-one basis. /s/ Jordan Davis and Daniel Lubin, each, individually, and as Managing Member of Radius Venture Partners III, LLC 2016-08-04