0001209191-20-054816.txt : 20201014
0001209191-20-054816.hdr.sgml : 20201014
20201014174514
ACCESSION NUMBER: 0001209191-20-054816
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20201012
FILED AS OF DATE: 20201014
DATE AS OF CHANGE: 20201014
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Mejia Richard Jr
CENTRAL INDEX KEY: 0001445578
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38677
FILM NUMBER: 201239792
MAIL ADDRESS:
STREET 1: 2200 FARADAY AVENUE
STREET 2: SUITE 100
CITY: CARLSBAD
STATE: CA
ZIP: 92008
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Ra Medical Systems, Inc.
CENTRAL INDEX KEY: 0001716621
STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841]
IRS NUMBER: 383661826
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 2070 LAS PALMAS DRIVE
CITY: CARLSBAD
STATE: CA
ZIP: 92011
BUSINESS PHONE: (760) 804-1648
MAIL ADDRESS:
STREET 1: 2070 LAS PALMAS DRIVE
CITY: CARLSBAD
STATE: CA
ZIP: 92011
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2020-10-12
0
0001716621
Ra Medical Systems, Inc.
RMED
0001445578
Mejia Richard Jr
C/O RA MEDICAL SYSTEMS, INC.
2070 LAS PALMAS DRIVE
CARLSBAD
CA
92011
1
0
0
0
Common Stock
2020-10-12
4
A
0
100000
0.00
A
188085
D
Reported shares represents a grant of restricted stock awards (the "RSAs") pursuant to Ra Medical Systems, Inc.'s 2018 Equity Incentive Plan. Each restricted stock award represents a contingent right to receive one share of Ra Medical Systems, Inc. common stock. The RSAs will vest on the earlier of (i) October 12, 2021, or (ii) the day prior to the date of the Annual Meeting next following October 12, 2020, subject to the reporting person's continued service.
/s/ Daniel Horwood, as Attorney-in-Fact
2020-10-14