0001437749-21-027829.txt : 20211203 0001437749-21-027829.hdr.sgml : 20211203 20211203160805 ACCESSION NUMBER: 0001437749-21-027829 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211201 FILED AS OF DATE: 20211203 DATE AS OF CHANGE: 20211203 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Erickson Stan K. CENTRAL INDEX KEY: 0001626702 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34839 FILM NUMBER: 211470049 MAIL ADDRESS: STREET 1: 10380 28TH AVENUE NORTH CITY: MINNEAPOLIS STATE: MN ZIP: 55441 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Electromed, Inc. CENTRAL INDEX KEY: 0001488917 STANDARD INDUSTRIAL CLASSIFICATION: ELECTROMEDICAL & ELECTROTHERAPEUTIC APPARATUS [3845] IRS NUMBER: 411732920 FISCAL YEAR END: 0630 BUSINESS ADDRESS: STREET 1: 500 SIXTH AVENUE NW CITY: NEW PRAGUE STATE: MN ZIP: 56071 BUSINESS PHONE: 952-758-9299 MAIL ADDRESS: STREET 1: 500 SIXTH AVENUE NW CITY: NEW PRAGUE STATE: MN ZIP: 56071 4 1 rdgdoc.xml FORM 4 X0306 4 2021-12-01 0001488917 Electromed, Inc. ELMD 0001626702 Erickson Stan K. 500 SIXTH AVENUE NW NEW PRAGUE MN 56071 1 Common Stock 2021-12-01 4 A 0 3000 0 A 26817 D Common Stock 1500 I By Liberty Capital, LP Restricted Stock scheduled to vest on June 1, 2022, unless earlier accelerated or terminated pursuant to their terms. The reporting person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein, and the inclusion of these shares in this report shall not be deemed an admission of beneficial ownership of all of the reported shares for purposes of Section 16 or for any other purpose. /s/ Joshua L. Colburn, Attorney-in-Fact 2021-12-03