0001209191-20-032399.txt : 20200527
0001209191-20-032399.hdr.sgml : 20200527
20200527182137
ACCESSION NUMBER: 0001209191-20-032399
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20200527
FILED AS OF DATE: 20200527
DATE AS OF CHANGE: 20200527
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Cooperatieve Gilde Healthcare IV U.A.
CENTRAL INDEX KEY: 0001756335
STATE OF INCORPORATION: P7
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39293
FILM NUMBER: 20916510
BUSINESS ADDRESS:
STREET 1: NEWTONLANN 51
CITY: UTRECHT
STATE: P7
ZIP: 3508AB
BUSINESS PHONE: 949-396-6322
MAIL ADDRESS:
STREET 1: NEWTONLANN 51
CITY: UTRECHT
STATE: P7
ZIP: 3508AB
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Gilde Healthcare IV Management B.V.
CENTRAL INDEX KEY: 0001757508
STATE OF INCORPORATION: P7
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39293
FILM NUMBER: 20916511
BUSINESS ADDRESS:
STREET 1: NEWTONLAAN 91
CITY: UTRECHT
STATE: P7
ZIP: 3584 BP
BUSINESS PHONE: 949-396-6322
MAIL ADDRESS:
STREET 1: NEWTONLAAN 91
CITY: UTRECHT
STATE: P7
ZIP: 3584 BP
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Gilde Healthcare Holding B.V.
CENTRAL INDEX KEY: 0001420106
STATE OF INCORPORATION: P7
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39293
FILM NUMBER: 20916512
BUSINESS ADDRESS:
STREET 1: NEWTONLAAN 91
STREET 2: PO BOX 85067
CITY: 3508 UTRECHT
STATE: P7
ZIP: AB
BUSINESS PHONE: 31(0)30-2192549
MAIL ADDRESS:
STREET 1: NEWTONLAAN 91
STREET 2: PO BOX 85067
CITY: 3508 UTRECHT
STATE: P7
ZIP: AB
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Inari Medical, Inc.
CENTRAL INDEX KEY: 0001531048
STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841]
IRS NUMBER: 452902923
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 9 PARKER, SUITE 100
CITY: IRVINE
STATE: CA
ZIP: 92618
BUSINESS PHONE: 949-923-4747
MAIL ADDRESS:
STREET 1: 9 PARKER, SUITE 100
CITY: IRVINE
STATE: CA
ZIP: 92618
FORMER COMPANY:
FORMER CONFORMED NAME: Inceptus Newco1 Inc.
DATE OF NAME CHANGE: 20110923
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2020-05-27
0
0001531048
Inari Medical, Inc.
NARI
0001756335
Cooperatieve Gilde Healthcare IV U.A.
NEWTONLAAN 91 3584 BP
UTRECHT
P7
NETHERLANDS
0
0
1
0
0001757508
Gilde Healthcare IV Management B.V.
NEWTONLAAN 91 3584 BP
UTRECHT
P7
NETHERLANDS
0
0
1
0
0001420106
Gilde Healthcare Holding B.V.
NEWTONLAAN 91 3584 BP
UTRECHT
P7
NETHERLANDS
0
0
1
0
Common Stock
2020-05-27
4
P
0
342329
19.00
A
342329
I
See footnote
Common Stock
2020-05-27
4
C
0
7599350
A
7941679
I
See footnote
Series C Preferred Stock
2020-05-27
4
C
0
7599350
D
Common Stock
7599350
0
I
See footnote
All securities reported are held of record by Cooperatieve Gilde Healthcare IV U.A. ("Gilde"). Gilde is managed by Gilde Healthcare IV Management B.V. ("Management"). Management is owned by Gilde Healthcare Holding B.V. ("Holding"). Each of Management and Holding may be deemed to have voting, investment and dispositive power with respect to the securities held by Gilde. Each of Management and Holding disclaims beneficial ownership of these securities and this report shall not be deemed an admission that any of them is the beneficial owner of such securities, except to the extent of their respective pecuniary interests therein.
Upon the closing of the Issuer's initial public offering, each share of preferred stock automatically converted into shares of the Issuer's common stock on a one-for-one basis.
Cooperatieve Gilde Healthcare IV U.A., By: /s/ Mitchell Hill, Name: Mitchell Hill, Title: Attorney-in-Fact
2020-05-27
Gilde Healthcare IV Management B.V., By: /s/ Mitchell Hill, Name: Mitchell Hill, Title: Attorney-in-Fact
2020-05-27
Gilde Healthcare Holding B.V., By: /s/ Mitchell Hill, Name: Mitchell Hill, Title: Attorney-in-Fact
2020-05-27