0001209191-18-036541.txt : 20180607
0001209191-18-036541.hdr.sgml : 20180607
20180607203524
ACCESSION NUMBER: 0001209191-18-036541
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20180605
FILED AS OF DATE: 20180607
DATE AS OF CHANGE: 20180607
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Simon Nicholas
CENTRAL INDEX KEY: 0001431403
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36709
FILM NUMBER: 18887904
MAIL ADDRESS:
STREET 1: 101 MAIN STREET SUITE 1210
CITY: CAMBRIDGE
STATE: MA
ZIP: 02142
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Sientra, Inc.
CENTRAL INDEX KEY: 0001551693
STANDARD INDUSTRIAL CLASSIFICATION: ORTHOPEDIC, PROSTHETIC & SURGICAL APPLIANCES & SUPPLIES [3842]
IRS NUMBER: 205551000
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 420 SOUTH FAIRVIEW AVENUE
STREET 2: SUITE 200
CITY: SANTA BARBARA
STATE: CA
ZIP: 93117
BUSINESS PHONE: 805.679.8838
MAIL ADDRESS:
STREET 1: 420 SOUTH FAIRVIEW AVENUE
STREET 2: SUITE 200
CITY: SANTA BARBARA
STATE: CA
ZIP: 93117
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2018-06-05
0
0001551693
Sientra, Inc.
SIEN
0001431403
Simon Nicholas
420 SOUTH FAIRVIEW AVENUE, SUITE 200
SANTA BARBARA
CA
93117
1
0
0
0
Common Stock (RSUs)
2018-06-05
4
A
0
6116
20.44
A
37662
D
Common Stock
2730765
I
See Note
The Common Stock underlying this grant of restricted stock will vest on the earlier to occur of: (i) the day prior to the annual meeting of stockholders for the year following the date of grant or (ii) the one (1) year anniversary of the annual meeting of stockholders of the year of grant, subject to continued service as a director of the Issuer.
Consists of 2,730,765 shares held of record by Clarus Lifesciences I, L.P. ("Clarus I"). Clarus Ventures I Management, L.P. ("Clarus I GPLP") is the sole general partner of Clarus I. Clarus Ventures I, LLC ("Clarus I GPLLC") is the sole general partner of Clarus I GPLP. Mr. Simon is a managing director of Clarus I GPLLC and may be deemed to beneficially own certain of the shares held of record by Clarus I. Mr. Simon disclaims beneficial ownership of all shares held of record by Clarus I, except to the extent of his pecuniary interest therein.
/s/ Oliver Bennett, Attorney-in-Fact
2018-06-07