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