0001104659-18-061740.txt : 20181012
0001104659-18-061740.hdr.sgml : 20181012
20181012114831
ACCESSION NUMBER: 0001104659-18-061740
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20181010
FILED AS OF DATE: 20181012
DATE AS OF CHANGE: 20181012
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Tansey Casey M
CENTRAL INDEX KEY: 0001474322
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38468
FILM NUMBER: 181119670
MAIL ADDRESS:
STREET 1: 2735 SAND HILL ROAD
CITY: MENLO PARK
STATE: CA
ZIP: 94025
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Inspire Medical Systems, Inc.
CENTRAL INDEX KEY: 0001609550
STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841]
IRS NUMBER: 261377674
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 9700 63RD AVENUE N
STREET 2: SUITE 200
CITY: MAPLE GROVE
STATE: X1
ZIP: 55369
BUSINESS PHONE: 763-205-7970
MAIL ADDRESS:
STREET 1: 9700 63RD AVENUE N
STREET 2: SUITE 200
CITY: MAPLE GROVE
STATE: X1
ZIP: 55369
4
1
a4.xml
4
X0306
4
2018-10-10
0
0001609550
Inspire Medical Systems, Inc.
INSP
0001474322
Tansey Casey M
C/O INSPIRE MEDICAL SYSTEMS, INC.
9700 63RD AVENUE NORTH, SUITE 200
MAPLE GROVE
MN
55369
1
0
1
0
Common Stock
2018-10-10
4
A
0
338
40.60
A
188045
D
Common Stock
2168254
I
See Footnote
Represents shares of vested, restricted common stock received in lieu of cash fees pursuant to the Issuer's Non-Employee Director Compensation Policy, which shares are subject to the Reporting Person's lock-up agreement entered into in connection with the Registrant's initial public offering.
The shares are held of record by U.S. Venture Partners IX, L.P. ("USVP IX"). Presidio Management Group IX, LLC ("PMG IX") is the general partner of USVP IX and may be deemed to have sole voting and dispositive power over the shares held by USVP IX. Casey Tansey, a director of the Issuer, and each of Irwin Federman, Steven M. Krausz, David E. Liddle, Paul A. Matteucci, Jonathan D. Root, and Philip M. Young, are managing members of PMG IX, and may be deemed to share voting and dispositive power over the shares held by USVP IX. Such persons and entities disclaim beneficial ownership of shares held by USVP IX, except to the extent of any proportionate pecuniary interest therein.
/s/ Richard Buchholz, Attorney-in-Fact
2018-10-12