0001209191-17-053407.txt : 20170919 0001209191-17-053407.hdr.sgml : 20170919 20170919211525 ACCESSION NUMBER: 0001209191-17-053407 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170918 FILED AS OF DATE: 20170919 DATE AS OF CHANGE: 20170919 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Roberts Brandi CENTRAL INDEX KEY: 0001516354 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-54192 FILM NUMBER: 171093157 MAIL ADDRESS: STREET 1: 12390 EL CAMINO REAL #150 CITY: SAN DIEGO STATE: CA ZIP: 92130 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: REVA Medical, Inc. CENTRAL INDEX KEY: 0001496268 STANDARD INDUSTRIAL CLASSIFICATION: ORTHOPEDIC, PROSTHETIC & SURGICAL APPLIANCES & SUPPLIES [3842] IRS NUMBER: 330810505 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 5751 COPLEY DRIVE CITY: SAN DIEGO STATE: CA ZIP: 92111 BUSINESS PHONE: (858) 966-3000 MAIL ADDRESS: STREET 1: 5751 COPLEY DRIVE CITY: SAN DIEGO STATE: CA ZIP: 92111 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2017-09-18 0 0001496268 REVA Medical, Inc. RVA:AX 0001516354 Roberts Brandi 5751 COPLEY DRIVE SAN DIEGO CA 92111 0 1 0 0 SVP & Chief Financial Officer Employee Stock Option (right to buy) 5.88 2017-09-18 4 A 0 190000 0.00 A 2027-09-18 Common Stock 190000 190000 D The option vests and becomes exercisable as follows: 25% of the option shares vest on September 18, 2018 with the remaining option shares vesting at the rate of 2.08333% per month thereafter until fully vested. /s/ Brandi Roberts 2017-09-19