0001209191-19-061916.txt : 20191226 0001209191-19-061916.hdr.sgml : 20191226 20191226160424 ACCESSION NUMBER: 0001209191-19-061916 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20191220 FILED AS OF DATE: 20191226 DATE AS OF CHANGE: 20191226 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Jackson Andrew C. CENTRAL INDEX KEY: 0001636738 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38677 FILM NUMBER: 191310608 MAIL ADDRESS: STREET 1: 11988 EL CAMINO REAL STE. 650 CITY: SAN DIEGO STATE: CA ZIP: 92130 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Ra Medical Systems, Inc. CENTRAL INDEX KEY: 0001716621 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 383661826 FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 2070 LAS PALMAS DRIVE CITY: CARLSBAD STATE: CA ZIP: 92011 BUSINESS PHONE: (760) 804-1648 MAIL ADDRESS: STREET 1: 2070 LAS PALMAS DRIVE CITY: CARLSBAD STATE: CA ZIP: 92011 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2019-12-20 0 0001716621 Ra Medical Systems, Inc. RMED 0001636738 Jackson Andrew C. C/O RA MEDICAL SYSTEMS, INC. 2070 LAS PALMAS DRIVE CARLSBAD CA 92011 0 1 0 0 CFO & Interim CEO Common Stock 2019-12-20 4 F 0 4641 0.901 D 25202 D Shares withheld by the issuer to satisfy the mandatory tax withholding requirement upon vesting of restricted stock units. This is not an open market sale of securities. /s/ Daniel Horwood, as Attorney-in-Fact 2019-12-23