0001209191-21-028322.txt : 20210426 0001209191-21-028322.hdr.sgml : 20210426 20210426171514 ACCESSION NUMBER: 0001209191-21-028322 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210426 FILED AS OF DATE: 20210426 DATE AS OF CHANGE: 20210426 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: LACOB JOSEPH CENTRAL INDEX KEY: 0001215490 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40337 FILM NUMBER: 21854942 MAIL ADDRESS: STREET 1: 2820 ORCHARD PARKWAY CITY: SAN JOSE STATE: CA ZIP: 95131 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: NeuroPace Inc CENTRAL INDEX KEY: 0001528287 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 223550230 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 455 N. BERNARDO AVENUE CITY: MOUNTAIN VIEW STATE: CA ZIP: 94043 BUSINESS PHONE: 6502372700 MAIL ADDRESS: STREET 1: 455 N. BERNARDO AVENUE CITY: MOUNTAIN VIEW STATE: CA ZIP: 94043 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2021-04-26 0 0001528287 NeuroPace Inc NPCE 0001215490 LACOB JOSEPH C/O NEUROPACE, INC. 455 N. BERNARDO AVENUE MOUNTAIN VIEW CA 95131 1 0 0 0 Common Stock 2021-04-26 4 A 0 334027 0.00 A 351920 I See Footnote Series A' Preferred Stock 0.00 2021-04-26 4 C 0 8594 0.00 D Common Stock 8594 0 I See Footnote Series A' Preferred Stock 0.00 2021-04-26 4 C 0 17189 0.00 D Common Stock 17189 0 I See Footnote Series B; Preferred Stock 0.00 2021-04-26 4 C 0 102747 0.00 D Common Stock 102747 0 I See Footnote Series B' Preferred Stock 0.00 2021-04-26 4 C 0 205497 0.00 D Common Stock 20549 0 I See Footnote Includes 111,341 shares held by Lacob Ventures LLC and 222,686 shares held by LCT18 Investments, LLC. Each share of Preferred Stock automatically converted on a 1-for-1 basis into Common Stock upon the closing of the Issuer's initial public offering, for no additional consideration. The Preferred Stock has no expiration date. Shares are held by Lacob Ventures LLC. Shares are held by LCT18 Investments. /s/ Mark B. Weeks, Attorney-in-Fact 2021-04-26