0000904454-18-000449.txt : 20180703 0000904454-18-000449.hdr.sgml : 20180703 20180703134645 ACCESSION NUMBER: 0000904454-18-000449 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20180629 FILED AS OF DATE: 20180703 DATE AS OF CHANGE: 20180703 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: DOVEY BRIAN H CENTRAL INDEX KEY: 0001207786 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-54192 FILM NUMBER: 18935977 MAIL ADDRESS: STREET 1: ONE PALMER SQUARE CITY: PRINCETON STATE: NJ ZIP: 08542 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: REVA Medical, Inc. CENTRAL INDEX KEY: 0001496268 STANDARD INDUSTRIAL CLASSIFICATION: ORTHOPEDIC, PROSTHETIC & SURGICAL APPLIANCES & SUPPLIES [3842] IRS NUMBER: 330810505 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 5751 COPLEY DRIVE CITY: SAN DIEGO STATE: CA ZIP: 92111 BUSINESS PHONE: (858) 966-3000 MAIL ADDRESS: STREET 1: 5751 COPLEY DRIVE CITY: SAN DIEGO STATE: CA ZIP: 92111 4 1 edgar.xml PRIMARY DOCUMENT X0306 4 2018-06-29 0001496268 REVA Medical, Inc. RVA 0001207786 DOVEY BRIAN H C/O DOMAIN ASSOCIATES, LLC ONE PALMER SQUARE PRINCETON NJ 08542 1 0 0 0 Common Stock 2018-06-29 4 J 0 3000 0 D 15500 D Common Stock 2018-06-29 4 J 0 3000 0 A 15500 I By Domain Associates, LLC Common Stock 3606002 I By Domain Partners V, L.P. Common Stock 85186 I By DP V Associates, L.P. An award of 6,000 Restricted Stock Units was made to the Reporting Person in July 2017, which vested in May 2018. Pursuant to the limited liability company agreement of Domain Associates, LLC, 50% of the vested shares subject to this award were transferred to Domain Associates, LLC. The Reporting Person is a Managing Member of One Palmer Square Associates V, LLC, which is the sole general partner of Domain Partners V, L.P. and DP V Associates, L.P., and a Managing Member of Domain Associates, LLC. The Reporting Person has elected to report as indirectly beneficially owned the entire number of securities beneficially owned by each such entity. The Reporting Person disclaims beneficial ownership of any securities, and any proceeds thereof, that exceed his pecuniary interest therein and/or that are not actually distributed to him. /s/ Lisa A. Kraeutler, Attorney-in-Fact 2018-07-03