0001104659-24-022562.txt : 20240213
0001104659-24-022562.hdr.sgml : 20240213
20240213213714
ACCESSION NUMBER: 0001104659-24-022562
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20240209
FILED AS OF DATE: 20240213
DATE AS OF CHANGE: 20240213
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Herbert Timothy P.
CENTRAL INDEX KEY: 0001737136
ORGANIZATION NAME:
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38468
FILM NUMBER: 24631615
MAIL ADDRESS:
STREET 1: C/O INSPIRE MEDICAL SYSTEMS, INC.
STREET 2: 9700 63RD AVENUE NORTH, SUITE 200
CITY: MAPLE GROVE
STATE: MN
ZIP: 55369
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Inspire Medical Systems, Inc.
CENTRAL INDEX KEY: 0001609550
STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841]
ORGANIZATION NAME: 08 Industrial Applications and Services
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
tm245999-3_4seq1.xml
OWNERSHIP DOCUMENT
X0508
4
2024-02-09
0
0001609550
Inspire Medical Systems, Inc.
INSP
0001737136
Herbert Timothy P.
C/O INSPIRE MEDICAL SYSTEMS, INC.
5500 WAYZATA BLVD., SUITE 1600
GOLDEN VALLEY
MN
55416
1
1
0
0
CEO and President
0
Common Stock
2024-02-09
4
A
0
8467
0.00
A
9690
D
Common Stock
117658
I
By LLC
Common Stock
115731
I
By Family Trust
Common Stock
103658
I
By Trust
Employee Stock Option (Right to Buy)
194.87
2024-02-09
4
A
0
13755
0.00
A
2034-02-09
Common Stock
13755
13755
D
Represents an award of restricted stock units, which vests in three equal annual installments commencing on February 9, 2025. Each restricted stock unit represents a contingent right to receive one share of Issuer's common stock, subject to the Reporting Person's continuous employment with the Issuer through the relevant vesting dates.
Includes (i) 58 shares acquired under the Issuer's 2018 Employee Stock Purchase Plan (the "Plan") on June 30, 2023 and (ii) 32 shares acquired under the Plan on December 31, 2023.
Corrects a clerical error in the Reporting Person's prior Form 4, dated March 16, 2023.
Securities held by the TPH 2022 LLC.
Securities held by the Timothy P. Herbert 2013 Family Irrevocable GST Trust U/A/D November 27, 2013.
Securities held by the Timothy P. Herbert 2018 Family Continuation Trust c/u the Timothy P. Herbert 2018 Grantor Retained Annuity Trust.
The option vests and becomes exercisable as to 25% of the underlying shares on February 9, 2025. The remaining 75% of the underlying shares will vest and become exercisable in 36 equal monthly installments thereafter, subject to the Reporting Person's continuous employment with the Issuer through the relevant vesting dates.
/s/ Bryan Phillips, Attorney-in-Fact for Timothy P. Herbert
2024-02-13