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