0001235802-21-000118.txt : 20210913 0001235802-21-000118.hdr.sgml : 20210913 20210913162513 ACCESSION NUMBER: 0001235802-21-000118 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210910 FILED AS OF DATE: 20210913 DATE AS OF CHANGE: 20210913 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Dube Joel F. CENTRAL INDEX KEY: 0001681006 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38740 FILM NUMBER: 211249957 MAIL ADDRESS: STREET 1: 100 DOMAIN DRIVE CITY: EXETER STATE: NH ZIP: 03833 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 primary_doc.xml PRIMARY DOCUMENT X0306 4 2021-09-10 0 0001253176 VAPOTHERM INC VAPO 0001681006 Dube Joel F. 100 DOMAIN DRIVE EXETER NH 03833 0 1 0 0 Chief Accounting Officer Common Stock 2021-09-10 4 M 0 416 12.16 A 4516 D Common Stock 2021-09-10 4 M 0 580 12.28 A 5096 D Common Stock 2021-09-10 4 S 0 996 29.1 D 4100 D Stock Option (right to buy) 12.16 2021-09-10 4 M 0 416 0 D 2030-01-01 Common Stock 416 4584 D Stock Option (right to buy) 12.28 2021-09-10 4 M 0 580 0 D 2030-01-20 Common Stock 580 6420 D Includes 4,100 shares that will be issued over time upon vesting pursuant to restricted stock units granted under the Vapotherm, Inc. 2018 Equity Incentive Plan. This option is eligible to vest as to 25% of the underlying shares on January 1, 2021, and thereafter, as to the remaining 75% of underlying shares, in 36 monthly installments, provided that the Reporting Person continues to serve as an employee or other service provider to the Issuer on each vesting date and otherwise subject to the Company's applicable equity incentive plan. This option is eligible to vest as to 25% of the underlying shares on December 2, 2020, and thereafter, as to the remaining 75% of underlying shares, in 36 monthly installments, provided that the Reporting Person continues to serve as an employee or other service provider to the Issuer on each vesting date and otherwise subject to the Company's applicable equity incentive plan. /s/ Adrain Bryant, as Attorney In Fact 2021-09-13