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