0001548538-21-000016.txt : 20210318 0001548538-21-000016.hdr.sgml : 20210318 20210318183752 ACCESSION NUMBER: 0001548538-21-000016 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210316 FILED AS OF DATE: 20210318 DATE AS OF CHANGE: 20210318 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: US VENTURE PARTNERS X LP CENTRAL INDEX KEY: 0001440514 STATE OF INCORPORATION: DE FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39293 FILM NUMBER: 21755862 BUSINESS ADDRESS: STREET 1: 2735 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: 650-854-9080 MAIL ADDRESS: STREET 1: 2735 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: USVP X AFFILIATES LP CENTRAL INDEX KEY: 0001453359 STATE OF INCORPORATION: DE FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39293 FILM NUMBER: 21755861 BUSINESS ADDRESS: STREET 1: 2735 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: 650-854-9080 MAIL ADDRESS: STREET 1: 2735 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Presidio Management Group X LLC CENTRAL INDEX KEY: 0001602744 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39293 FILM NUMBER: 21755863 BUSINESS ADDRESS: STREET 1: 2735 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: 650-854-9080 MAIL ADDRESS: STREET 1: 2735 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Tansey Casey M CENTRAL INDEX KEY: 0001474322 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39293 FILM NUMBER: 21755860 MAIL ADDRESS: STREET 1: 2735 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 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 edgar.xml PRIMARY DOCUMENT X0306 4 2021-03-16 1 0001531048 Inari Medical, Inc. NARI 0001602744 Presidio Management Group X LLC 1460 EL CAMINO REAL, SUITE 100 MENLO PARK CA 94025 0 0 1 0 0001440514 US VENTURE PARTNERS X LP 1460 EL CAMINO REAL, SUITE 100 MENLO PARK CA 94025 0 0 1 0 0001453359 USVP X AFFILIATES LP 1460 EL CAMINO REAL, SUITE 100 MENLO PARK CA 94025 0 0 1 0 0001474322 Tansey Casey M 1460 EL CAMINO REAL, SUITE 100 MENLO PARK CA 94025 0 0 1 0 Common Stock 2021-03-16 4 J 0 2619872 D 2619872 I Directly owned by USVP X Common Stock 2021-03-16 4 J 0 83814 D 83813 I Directly owned by AFF X Common Stock 2021-03-16 4 J 0 685827 A 685827 I Directly owned by PMG X. Common Stock 2021-03-16 4 J 0 685827 D 0 I Directly owned by PMG X. Common Stock 2021-03-16 4 J 0 77296 A 242988 I Directly owned by Tansey Represents a pro-rata in-kind distribution of the Issuer's common stock, and not a purchase or sale, without additional consideration to their respective partners, members and assignees, as applicable. Represents a pro-rata in-kind distribution of the Issuer's common stock held directly by each of U.S. Venture Partners X, L.P. ("USVP X") and USVP X Affiliates Fund, L.P. ("AFF X" and, together with USVP X, the "USVP X Funds"), and may be deemed to have sole voting and dispositive power over the securities held by the USVP X Funds. Casey Tansey is the sole managing partner of PMG X and may be deemed to have shared voting and sole dispositive power over the reported securities held by the USVP X Funds, and disclaims beneficial ownership of such securities, except to the extent of any pecuniary interest therein. Represents a pro-rata in-kind distribution of the Issuer's common stock to PMG X from each of the USVP Funds, without additional consideration. Casey Tansey is the sole managing partner of PMG X and may be deemed to have shared voting and sole dispositive power over the reported securities held by PMG X, and disclaims beneficial ownership of such securities, except to the extent of any pecuniary interest therein. Represents a pro-rata in-kind distribution of the Issuer's common stock held directly by PMG X, without additional consideration, to its members (the "PMG X Distribution"). Casey Tansey is the sole managing partner of PMG X and may be deemed to have shared voting and sole dispositive power over the reported securities held by PMG X, and disclaims beneficial ownership of such securities, except to the extent of any pecuniary interest therein. Represents a change in the form of ownership from indirect to direct by virtue of the receipt of shares in the PMG X Distribution. Dale Holladay -Attorney in Fact for each Reporting Person 2021-03-18