0001209191-20-045187.txt : 20200805
0001209191-20-045187.hdr.sgml : 20200805
20200805171052
ACCESSION NUMBER: 0001209191-20-045187
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20200803
FILED AS OF DATE: 20200805
DATE AS OF CHANGE: 20200805
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: 201078550
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
2020-08-03
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
Common Stock
2020-08-03
4
P
0
10000
0.35
A
50202
D
Warrants (right to buy)
0.35
2020-08-03
4
P
0
10000
0.00
A
2020-08-03
2025-08-04
Common Stock
10000
10000
D
/s/ Daniel Horwood, as Attorney-in-Fact
2020-08-05