0001104659-19-027222.txt : 20190506 0001104659-19-027222.hdr.sgml : 20190506 20190506180804 ACCESSION NUMBER: 0001104659-19-027222 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190502 FILED AS OF DATE: 20190506 DATE AS OF CHANGE: 20190506 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Jain Mudit K. CENTRAL INDEX KEY: 0001584404 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38468 FILM NUMBER: 19800684 MAIL ADDRESS: STREET 1: 3284 ALPINE ROAD CITY: PORTOLA VALLEY STATE: CA ZIP: 94028 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: 5500 WAYZATA BLVD STREET 2: SUITE 1600 CITY: GOLDEN VALLEY STATE: MN ZIP: 55416 BUSINESS PHONE: 763-957-5037 MAIL ADDRESS: STREET 1: 5500 WAYZATA BLVD STREET 2: SUITE 1600 CITY: GOLDEN VALLEY STATE: MN ZIP: 55416 4 1 a4.xml 4 X0306 4 2019-05-02 0 0001609550 Inspire Medical Systems, Inc. INSP 0001584404 Jain Mudit K. C/O INSPIRE MEDICAL SYSTEMS, INC. 5500 WAYZATA BLVD., SUITE 1600 GOLDEN VALLEY MN 55416 1 0 0 0 Stock Option (right to buy) 49.96 2019-05-02 4 A 0 4569 0 A 2029-05-02 Common Stock 4569 4569 D The option vests and becomes exercisable on May 2, 2020, subject to the Reporting Person's continuous service to the Issuer through such date. /s/ Richard Buchholz, as Attorney-in-Fact for Mudit K. Jain 2019-05-06