0001225208-17-016194.txt : 20171011
0001225208-17-016194.hdr.sgml : 20171011
20171011165354
ACCESSION NUMBER: 0001225208-17-016194
CONFORMED SUBMISSION TYPE: 3
PUBLIC DOCUMENT COUNT: 2
CONFORMED PERIOD OF REPORT: 20171011
FILED AS OF DATE: 20171011
DATE AS OF CHANGE: 20171011
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Speiser Michael L
CENTRAL INDEX KEY: 0001433644
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38238
FILM NUMBER: 171132994
MAIL ADDRESS:
STREET 1: 755 PAGE MILL ROAD, SUITE A-200
CITY: PALO ALTO
STATE: CA
ZIP: 94304-1005
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Restoration Robotics Inc
CENTRAL INDEX KEY: 0001409269
STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841]
IRS NUMBER: 061681204
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 128 BAYTECH DRIVE
CITY: SAN JOSE
STATE: CA
ZIP: 95134
BUSINESS PHONE: 408-883-6888
MAIL ADDRESS:
STREET 1: 128 BAYTECH DRIVE
CITY: SAN JOSE
STATE: CA
ZIP: 95134
3
1
doc3.xml
X0206
3
2017-10-11
0
0001409269
Restoration Robotics Inc
HAIR
0001433644
Speiser Michael L
755 PAGE MILL RD., SUITE A-200
PALO ALTO
CA
94304-1005
1
Series C Preferred Stock
Common Stock
14818.0000
I
By Ltd Partnership (CHAT)
Series A Preferred Stock
Common Stock
479145.0000
I
By Ltd Partnership (SHV)
Series B Preferred Stock
Common Stock
606386.0000
I
By Ltd Partnership (SHV)
Series C Preferred Stock
Common Stock
888690.0000
I
By Ltd Partnership (SHV)
Series C Preferred Stock
Common Stock
3600.0000
I
By Profit Sharing Plan Trust
Series A Preferred Stock
Common Stock
35468.0000
I
By Trust
Series B Preferred Stock
Common Stock
44893.0000
I
By Trust
Series C Preferred Stock
Common Stock
53905.0000
I
By Trust
The issuer's preferred stock will automatically convert into issuer's common stock on a one-to-one basis immediately prior to the closing of the issuer's initial public offering and has no expiration date.
Shares held by a limited partnership of which the reporting person is a trustee of a trust which is the general partner. The reporting person disclaims beneficial ownership in these shares except as to the reporting person's pecuniary interest therein.
Shares held by Sutter Hill Ventures, a California Limited Partnership. The reporting person is a managing director and member of the management committee of the general partner of Sutter Hill Ventures, a California Limited Partnership. The reporting person disclaims beneficial ownership in these shares except as to the reporting person's pecuniary interest therein.
Shares held by the SHV Profit Sharing Plan, a retirement trust, for the benefit of the reporting person.
Shares held by a trust of which the reporting person is a trustee. The reporting person disclaims beneficial ownership in these shares except as to the reporting person's pecuniary interest therein.
hairmls.txt
/s/ Robert Yin, by power of attorney
2017-10-11
EX-24
2
hairmls.txt
POWER OF ATTORNEY
Know all by these presents, that the undersigned hereby authorizes
David E. Sweet, Robert Yin, or Patricia Tom to execute for and on behalf of
the undersigned Forms 3, 4, and 5, and any Amendments thereto for Restoration
Robotics, Inc. (the "Company"), and cause such form(s) to be filed with the
United States Securities and Exchange Commission pursuant to Section 16(a)
of the Securities Act of 1934, relating to the undersigned's beneficial
ownership of securities in the Company. The undersigned hereby grants to
each such attorney-in-fact full power and authority to do and perform any
and every act and thing whatsoever requisite, necessary, or proper to be
done in the exercise of any of the rights and powers herein granted, as
fully to all intents and purposes as the undersigned might or could do if
personally present, with full power of substitution or revocation, hereby
ratifying and confirming all that such attorney-in-fact, or such attorney-
in-fact's substitute or substitutes, shall lawfully do or cause to be done
by virtue of this power of attorney and the rights and powers herein granted.
The undersigned acknowledges that the foregoing attorneys-in-fact, in serving
in such a capacity at the request of the undersigned, are not assuming, nor
is the Company assuming, any of the undersigned's responsibilities to comply
with Section 16 of the Securities Exchange Act of 1934.
This Power of Attorney shall remain in full force and effect until
the undersigned is no longer required to file Forms 3, 4, and 5 with respect
to the undersigned's holdings of, and transactions in, securities issued by
the Company, unless earlier revoked by the undersigned in a signed writing
delivered to the foregoing attorneys-in-fact.
In witness whereof, the undersigned has caused this Power of Attorney
to be executed as of this 6th day of October, 2017.
/s/ Michael L. Speiser