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