0001209191-18-054439.txt : 20181005
0001209191-18-054439.hdr.sgml : 20181005
20181005181506
ACCESSION NUMBER: 0001209191-18-054439
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20181004
FILED AS OF DATE: 20181005
DATE AS OF CHANGE: 20181005
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: COLOMBATTO MARTIN J
CENTRAL INDEX KEY: 0001208236
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38677
FILM NUMBER: 181111520
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Ra Medical Systems, Inc.
CENTRAL INDEX KEY: 0001716621
STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841]
IRS NUMBER: 363661826
STATE OF INCORPORATION: CA
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 2070 LAS PALMAS DRIVE
CITY: CARLSBAD
STATE: CA
ZIP: 92011
BUSINESS PHONE: (760) 804-1648
MAIL ADDRESS:
STREET 1: 2070 LAS PALMAS DRIVE
CITY: CARLSBAD
STATE: CA
ZIP: 92011
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2018-10-04
0
0001716621
Ra Medical Systems, Inc.
RMED
0001208236
COLOMBATTO MARTIN J
C/O RA MEDICAL SYSTEMS, INC.
2070 LAS PALMAS DRIVE
CARLSBAD
CA
92011
1
0
0
0
Common Stock
2018-10-04
4
A
0
8235
0.00
A
38625
D
Common Stock
37500
I
See Footnote
Reported shares are represented by restricted stock units ("RSUs"), and each RSU is the economic equivalent of one share of Ra Medical Systems, Inc. common stock. 1/3rd of the RSUs shall vest annually beginning on October 4, 2019 such that the RSUs will be fully vested on October 4, 2021, subject to the reporting person's continued service.
Shares held of record by the M Colombatto Trust, for which the reporting person serves as Trustee.
/s/ Andrew Jackson, as Attorney-in-Fact
2018-10-05