0001209191-18-031613.txt : 20180518 0001209191-18-031613.hdr.sgml : 20180518 20180518205517 ACCESSION NUMBER: 0001209191-18-031613 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20180516 FILED AS OF DATE: 20180518 DATE AS OF CHANGE: 20180518 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Breckenridge Ross CENTRAL INDEX KEY: 0001632114 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-54192 FILM NUMBER: 18848229 MAIL ADDRESS: STREET 1: 5751 COPLEY DRIVE CITY: SAN DIEGO STATE: CA ZIP: 92111 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 2018-05-16 0 0001496268 REVA Medical, Inc. RVA.AX 0001632114 Breckenridge Ross 5751 COPLEY DRIVE SAN DIEGO CA 92111 1 0 0 0 Stock Option (right to buy) 1.96 2018-05-16 4 A 0 25000 0.00 A 2028-05-16 Common Stock 25000 25000 D The option vests and becomes exercisable on May 16, 2019. /s/ Brandi Roberts, Attorney-in-Fact 2018-05-18