0000899243-18-029477.txt : 20181120 0000899243-18-029477.hdr.sgml : 20181120 20181120170947 ACCESSION NUMBER: 0000899243-18-029477 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20181116 FILED AS OF DATE: 20181120 DATE AS OF CHANGE: 20181120 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MORGENTHALER VENTURE PARTNERS IX LP CENTRAL INDEX KEY: 0001439101 STATE OF INCORPORATION: DE FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38740 FILM NUMBER: 181196216 BUSINESS ADDRESS: STREET 1: 2710 SAND HILL ROAD STREET 2: SUITE 100 CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: 650-388-7600 MAIL ADDRESS: STREET 1: 2710 SAND HILL ROAD STREET 2: SUITE 100 CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Morgenthaler Management Partners IX, LLC CENTRAL INDEX KEY: 0001666860 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38740 FILM NUMBER: 181196217 BUSINESS ADDRESS: STREET 1: 3200 ALPINE ROAD CITY: PORTOLA VALLEY STATE: CA ZIP: 94028 BUSINESS PHONE: 650-388-7600 MAIL ADDRESS: STREET 1: 3200 ALPINE ROAD CITY: PORTOLA VALLEY STATE: CA ZIP: 94028 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: VAPOTHERM INC CENTRAL INDEX KEY: 0001253176 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 100 DOMAIN DRIVE CITY: EXETER STATE: NH ZIP: 03833 BUSINESS PHONE: 603-658-0411 MAIL ADDRESS: STREET 1: 100 DOMAIN DRIVE CITY: EXETER STATE: NH ZIP: 03833 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2018-11-16 1 0001253176 VAPOTHERM INC VAPO 0001439101 MORGENTHALER VENTURE PARTNERS IX LP 3200 ALPINE ROAD PORTOLA VALLEY CA 94028 0 0 1 0 0001666860 Morgenthaler Management Partners IX, LLC 3200 ALPINE ROAD PORTOLA VALLEY CA 94028 0 0 1 0 Common Stock 2018-11-16 4 C 0 921348 A 921348 D Common Stock 2018-11-16 4 C 0 61342 A 982690 D Series A Convertible Preferred Stock 2018-11-16 4 C 0 214285 0.00 D Common Stock 214285 0 D Series B Convertible Preferred Stock 2018-11-16 4 C 0 217803 0.00 D Common Stock 217803 0 D Series C Convertible Preferred Stock 2018-11-16 4 C 0 359842 0.00 D Common Stock 359842 0 D Series D Convertible Preferred Stock 2018-11-16 4 C 0 129418 0.00 D Common Stock 129418 0 D Series D-1 Convertible Preferred Stock 2018-11-16 4 C 0 61342 0.00 D Common Stock 61342 0 D Upon closing of the Issuer's initial public offering, each share of Series A Convertible Preferred Stock, Series B Convertible Preferred Stock, Series C Convertible Preferred Stock and Series D Convertible Preferred Stock automatically converted into one share of Common Stock without payment or further consideration. There was no expiration date for the Series A Convertible Preferred Stock, the Series B Convertible Preferred Stock, the Series C Convertible Preferred Stock or the Series D Convertible Preferred Stock. Upon closing of the Issuer's initial public offering, each share of Series D-1 Convertible Preferred Stock automatically converted into 1.137 shares of Common Stock without payment or further consideration. There was no expiration date for the Series D-1 Convertible Preferred Stock. The securities are held by Morgenthaler Venture Partners IX, L.P. ("MVP IX"). The general partner of MVP IX is Morgenthaler Management Partners IX, LLC ("MMP IX"). MMP IX may be deemed to indirectly beneficially own the securities directly held by MVP IX. MMP IX disclaims beneficial ownership of the securities held by MVP IX except to the extent of its pecuniary interest therein. Morgenthaler Venture Partners IX, L.P., By: Morgenthaler Management Partners IX, LLC, its General Partner, By: /s/ Travis, Boettner, Chief Financial Officer and Chief, Compliance Officer 2018-11-20 Morgenthaler Management Partners IX, LLC, By: /s/ Travis Boettner, Chief Financial, Officer and Chief Compliance Officer 2018-11-20