0001209191-20-054987.txt : 20201015
0001209191-20-054987.hdr.sgml : 20201015
20201015202039
ACCESSION NUMBER: 0001209191-20-054987
CONFORMED SUBMISSION TYPE: 3
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20201015
FILED AS OF DATE: 20201015
DATE AS OF CHANGE: 20201015
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: BASKETT FOREST
CENTRAL INDEX KEY: 0001277631
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39616
FILM NUMBER: 201242536
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Eargo, Inc.
CENTRAL INDEX KEY: 0001719395
STANDARD INDUSTRIAL CLASSIFICATION: ORTHOPEDIC, PROSTHETIC & SURGICAL APPLIANCES & SUPPLIES [3842]
IRS NUMBER: 273879804
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 1600 TECHNOLOGY DRIVE
STREET 2: 6TH FLOOR
CITY: SAN JOSE
STATE: CA
ZIP: 95110
BUSINESS PHONE: 650-351-7700
MAIL ADDRESS:
STREET 1: 1600 TECHNOLOGY DRIVE
STREET 2: 6TH FLOOR
CITY: SAN JOSE
STATE: CA
ZIP: 95110
3
1
doc3.xml
FORM 3 SUBMISSION
X0206
3
2020-10-15
0
0001719395
Eargo, Inc.
EAR
0001277631
BASKETT FOREST
1954 GREENSPRING DRIVE
SUITE 600
TIMONIUM
MD
21093
0
0
1
0
Series B-1 Preferred Stock
Common Stock
1858716
I
See Note 3
Series C Preferred Stock
Common Stock
1426354
I
See Note 3
Series C-1 Preferred Stock
Common Stock
791214
I
See Note 3
Series D Preferred Stock
Common Stock
699163
I
See Note 3
Series E Preferred Stock
Common Stock
1433459
I
See Note 3
The shares of the Issuer's Series B-1 Preferred Stock automatically convert into shares of the Issuer's Common Stock, for no additional consideration, on a 1:3.400930233 basis immediately prior to the consummation of the Issuer's initial public offering.
The expiration date is not relevant to the conversion of these securities.
The Reporting Person is a manager of NEA 15 GP, LLC, which is the sole general partner of NEA Partners 15, L.P. ("NEA Partners 15"). NEA Partners 15 is the sole general partner of New Enterprise Associates 15, L.P. ("NEA 15"), which is the direct beneficial owner of the shares. The Reporting Person disclaims beneficial ownership within the meaning of Section 16 of the Securities Exchange Act of 1934, as amended, or otherwise of such portion of the shares held by NEA 15 in which the Reporting Person has no pecuniary interest.
The shares of the Issuer's Series C Preferred Stock automatically convert into shares of the Issuer's Common Stock, for no additional consideration, on a 1:1.118772093 basis immediately prior to the consummation of the Issuer's initial public offering.
The shares of the Issuer's Series C-1 Preferred Stock automatically convert into shares of the Issuer's Common Stock, for no additional consideration, on a 1:1.037033844 basis immediately prior to the consummation of the Issuer's initial public offering.
The shares of the Issuer's Series D Preferred Stock automatically convert into shares of the Issuer's Common Stock, for no additional consideration, on a 1:1.246748888 basis immediately prior to the consummation of the Issuer's initial public offering.
The shares of the Issuer's Series E Preferred Stock automatically convert into shares of the Issuer's Common Stock, for no additional consideration, on a 1:1 basis immediately prior to the consummation of the Issuer's initial public offering.
/s/ Sasha Keough, attorney-in-fact
2020-10-15