0000899243-20-031770.txt : 20201119 0000899243-20-031770.hdr.sgml : 20201119 20201119211811 ACCESSION NUMBER: 0000899243-20-031770 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20201117 FILED AS OF DATE: 20201119 DATE AS OF CHANGE: 20201119 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Versant Side Fund IV, L.P. CENTRAL INDEX KEY: 0001456591 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39293 FILM NUMBER: 201330330 BUSINESS ADDRESS: STREET 1: ONE SANSOME STREET STREET 2: SUITE 3630 CITY: SAN FRANCISCO STATE: CA ZIP: 94104 BUSINESS PHONE: 650-233-2211 MAIL ADDRESS: STREET 1: ONE SANSOME STREET STREET 2: SUITE 3630 CITY: SAN FRANCISCO STATE: CA ZIP: 94104 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Versant Venture Capital IV, L.P. CENTRAL INDEX KEY: 0001456590 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39293 FILM NUMBER: 201330331 BUSINESS ADDRESS: STREET 1: ONE SANSOME STREET STREET 2: SUITE 3630 CITY: SAN FRANCISCO STATE: CA ZIP: 94104 BUSINESS PHONE: 650-233-2211 MAIL ADDRESS: STREET 1: ONE SANSOME STREET STREET 2: SUITE 3630 CITY: SAN FRANCISCO STATE: CA ZIP: 94104 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Versant Ventures IV, LLC CENTRAL INDEX KEY: 0001456589 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39293 FILM NUMBER: 201330332 BUSINESS ADDRESS: STREET 1: ONE SANSOME STREET STREET 2: SUITE 3630 CITY: SAN FRANCISCO STATE: CA ZIP: 94104 BUSINESS PHONE: 650-233-2211 MAIL ADDRESS: STREET 1: ONE SANSOME STREET STREET 2: SUITE 3630 CITY: SAN FRANCISCO STATE: CA ZIP: 94104 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 2020-11-17 1 0001531048 Inari Medical, Inc. NARI 0001456589 Versant Ventures IV, LLC ONE SANSOME SUITE 3630 SAN FRANCISCO CA 94104 0 0 1 0 0001456590 Versant Venture Capital IV, L.P. ONE SANSOME SUITE 3630 SAN FRANCISCO CA 94104 0 0 1 0 0001456591 Versant Side Fund IV, L.P. ONE SANSOME SUITE 3630 SAN FRANCISCO CA 94104 0 0 1 0 Common Stock 2020-11-17 4 J 0 3004415 0.00 D 2705162 I See footnote Common Stock 2020-11-17 4 J 0 164825 0.00 A 164825 I See footnote Common Stock 2020-11-17 4 J 0 164825 0.00 D 0 I See footnote Common Stock 2020-11-17 4 J 0 18925 0.00 D 17040 I See footnote Represents a pro-rata distribution, and not a purchase or sale, without additional consideration by Versant Venture Capital IV, L.P. ("Versant IV"), to its partners, pursuant to a Rule 10b5-1 distribution plan. Shares held by Versant IV. Versant Ventures IV, LLC ("Versant Ventures IV GP") is the general partner of Versant IV. Kirk G. Nielsen is a managing member of Versant Ventures IV GP and may be deemed to share voting and dispositive power over the shares held by Versant IV; however, he disclaims beneficial ownership of such securities, except to the extent of his pecuniary interests therein. Kirk G. Nielsen is a director of the Issuer and, accordingly, files separate Section 16 reports. Represents a change in the form of ownership of Versant Ventures IV GP by virtue of the receipt of shares as a result of the pro-rata in-kind distribution of common stock of the Issuer for no consideration by Versant IV. Shares held by Versant Ventures IV GP. Kirk G. Nielsen is a managing member of Versant Ventures IV GP and may be deemed to share voting and dispositive power over the shares held by Versant Ventures IV GP; however, he disclaims beneficial ownership of such securities, except to the extent of his pecuniary interests therein. Kirk G. Nielsen is a director of the Issuer and, accordingly, files separate Section 16 reports. Represents a pro-rata distribution, and not a purchase or sale, without additional consideration by Versant Ventures IV GP to its members. Represents a pro-rata distribution, and not a purchase or sale, without additional consideration by Versant Side Fund IV, L.P. ("Versant Side Fund"), to its partners, pursuant to a Rule 10b5-1 distribution plan. Shares held by Versant Side Fund. Versant Ventures IV GP is the general partner of Versant Side Fund. Kirk G. Nielsen is a managing member of Versant Ventures IV GP and may be deemed to share voting and dispositive power over the shares held by Versant Side Fund; however, he disclaims beneficial ownership of such securities, except to the extent of his pecuniary interests therein. Kirk G. Nielsen is a director of the Issuer and, accordingly, files separate Section 16 reports. Versant Ventures IV, LLC, By: /s/ Robin L. Praeger, its managing director 2020-11-19 Versant Venture Capital IV, L.P., By: /s/ Versant Ventures IV, LLC, its general partner, By: Robin L. Praeger, its managing director 2020-11-19 Versant Side Fund IV, L.P., By: /s/ Versant Ventures IV, LLC, its general partner, By: Robin L. Praeger, its managing director 2020-11-19