0001104659-18-031862.txt : 20180509 0001104659-18-031862.hdr.sgml : 20180509 20180509211656 ACCESSION NUMBER: 0001104659-18-031862 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20180502 FILED AS OF DATE: 20180509 DATE AS OF CHANGE: 20180509 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Mead Dana G Jr. CENTRAL INDEX KEY: 0001222358 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38468 FILM NUMBER: 18820219 MAIL ADDRESS: STREET 1: 2750 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 FORMER NAME: FORMER CONFORMED NAME: MEAD DANA G JR DATE OF NAME CHANGE: 20030310 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Inspire Medical Systems, Inc. CENTRAL INDEX KEY: 0001609550 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 261377674 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 9700 63RD AVENUE N STREET 2: SUITE 200 CITY: MAPLE GROVE STATE: X1 ZIP: 55369 BUSINESS PHONE: 763-205-7970 MAIL ADDRESS: STREET 1: 9700 63RD AVENUE N STREET 2: SUITE 200 CITY: MAPLE GROVE STATE: X1 ZIP: 55369 4 1 a4.xml 4 X0306 4 2018-05-02 0 0001609550 Inspire Medical Systems, Inc. INSP 0001222358 Mead Dana G Jr. C/O INSPIRE MEDICAL SYSTEMS, INC. 9700 63RD AVENUE NORTH, SUITE 200 MAPLE GROVE MN 55369 1 0 0 0 Common Stock 2018-05-07 4 P 0 20000 16.00 A 20000 D Employee Stock Option (right to buy) 16.00 2018-05-02 4 A 0 17296 0 A 2028-05-02 Common Stock 17296 17296 D The option vests and becomes exercisable on May 2, 2019, subject to the Reporting Person's continuous service to the Issuer through such date. The option was erroneously included on the Reporting Person's Form 3 filed on May 2, 2018. /s/ Richard Buchholz, as Attorney-in-Fact for Dana G. Mead, Jr. 2018-05-09