0001209191-20-032420.txt : 20200527
0001209191-20-032420.hdr.sgml : 20200527
20200527184431
ACCESSION NUMBER: 0001209191-20-032420
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20200527
FILED AS OF DATE: 20200527
DATE AS OF CHANGE: 20200527
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: 20916551
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: 20916552
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 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: 20916553
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
2020-05-27
0
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
2020-05-27
4
C
0
5745542
A
5745542
I
See footnote
Series A Preferred Stock
2020-05-27
4
C
0
3571426
D
Common Stock
3571426
0
I
See footnote
Series B Preferred Stock
2020-05-27
4
C
0
1197058
D
Common Stock
1197058
0
I
See footnote
Series C Preferred Stock
2020-05-27
4
C
0
977058
D
Common Stock
977058
0
I
See footnote
Upon the closing of the Issuer's initial public offering, each share of preferred stock automatically converted into shares of the Issuer's common stock on a one-for-one
basis.
Includes (i) 3,549,070 shares held of record by Versant Venture Capital IV, L.P. ("Versant Capital") and (ii) 22,356 shares held of record by Versant Side Fund IV, L.P.
("Versant Side").
Includes (i) 1,189,565 shares held of record by Versant Capital and (ii) 7,493 shares held of record by Versant Side.
Includes (i) 970,942 shares held of record by Versant Capital and (ii) 6,116 shares held of record by Versant Side.
Versant Ventures IV, LLC ("VV IV") is the general partner of each of Versant Capital and Versant Side and, as a result, may be deemed to share voting and dispositive
power over the shares held by each of Versant Capital and Versant Side and disclaims beneficial ownership of such securities except to the extent of its pecuniary
interest therein. Each of Brian Atwood, Bradley J. Bolzon, Samuel Colella, Ross Jaffe, William Link, Kirk G. Nielsen, Robin L. Praeger, Rebecca Robertson, Charles Warden and Tom Woiwode Ph.D., as managing members of VV IV, may be deemed to share voting and dispositive power over the shares held by Versant Capital and
Versant Side and disclaim beneficial ownership of such securities except to the extent of their respective pecuniary interest therein. A Form 4 is being filed separately by Mr. Nielsen in his capacity as a director of the Issuer.
Versant Ventures IV, LLC, By: /s/ Robin L. Praeger, its managing director
2020-05-27
Versant Venture Capital IV, L.P., By: /s/ Versant Ventures IV, LLC, its general partner, By: Robin L. Praeger, its managing director
2020-05-27
Versant Side Fund IV, L.P., By: /s/ Versant Ventures IV, LLC, its general partner, By: Robin L. Praeger, its managing director
2020-05-27