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