0000950103-21-005125.txt : 20210402 0000950103-21-005125.hdr.sgml : 20210402 20210402164612 ACCESSION NUMBER: 0000950103-21-005125 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210401 FILED AS OF DATE: 20210402 DATE AS OF CHANGE: 20210402 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Burgess Vincent J CENTRAL INDEX KEY: 0001365408 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39430 FILM NUMBER: 21802549 MAIL ADDRESS: STREET 1: 2210 FARADAY AVE #100 CITY: CARLSBAD STATE: CA ZIP: 92008 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Acutus Medical, Inc. CENTRAL INDEX KEY: 0001522860 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 451306615 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 2210 FARADAY AVE STREET 2: SUITE 100 CITY: CARLSBAD STATE: CA ZIP: 92008 BUSINESS PHONE: 442-232-6080 MAIL ADDRESS: STREET 1: 2210 FARADAY AVE STREET 2: SUITE 100 CITY: CARLSBAD STATE: CA ZIP: 92008 4 1 dp148971_4-burgess.xml FORM 4 X0306 4 2021-04-01 0 0001522860 Acutus Medical, Inc. AFIB 0001365408 Burgess Vincent J C/O ACUTUS MEDICAL, INC. 2210 FARADAY AVE., SUITE 100 CARLSBAD CA 92008 1 1 0 0 Chief Executive Officer Common Stock 2021-04-01 4 A 0 45065 0 A 67287 D Stock Options (Right to Buy) 13.66 2021-04-01 4 A 0 158691 0 A 2031-04-01 Common Stock 158691 158691 D Represents shares of Common Stock to be delivered in settlement of a restricted stock unit award upon continued service through the designated vesting event. This option vests over four years from April 1, 2021, with 1/4 vesting on the first anniversary of the vesting commencement date, and the remainder vesting in 36 equal monthly installments, subject to continued service through each such vesting date. /s/ Tom Sohn as attorney-in-fact for Vincent J. Burgess 2021-04-02