0001493152-21-023354.txt : 20210922
0001493152-21-023354.hdr.sgml : 20210922
20210922150928
ACCESSION NUMBER: 0001493152-21-023354
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210921
FILED AS OF DATE: 20210922
DATE AS OF CHANGE: 20210922
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Huntsman Ronald Kirk
CENTRAL INDEX KEY: 0001835498
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39796
FILM NUMBER: 211269431
MAIL ADDRESS:
STREET 1: 9137 RIDGELINE BOULEVARD, SUITE 135
CITY: HIGHLANDS RANCH
STATE: CO
ZIP: 80129
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Vivos Therapeutics, Inc.
CENTRAL INDEX KEY: 0001716166
STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841]
IRS NUMBER: 813224056
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 9137 RIDGELINE BOULEVARD
STREET 2: SUITE 135
CITY: HIGHLANDS RANCH
STATE: CO
ZIP: 80129
BUSINESS PHONE: (866)908-4867
MAIL ADDRESS:
STREET 1: 9137 RIDGELINE BOULEVARD
STREET 2: SUITE 135
CITY: HIGHLANDS RANCH
STATE: CO
ZIP: 80129
FORMER COMPANY:
FORMER CONFORMED NAME: Vivos BioTechnologies, Inc.
DATE OF NAME CHANGE: 20170901
4
1
ownership.xml
X0306
4
2021-09-21
0
0001716166
Vivos Therapeutics, Inc.
VVOS
0001835498
Huntsman Ronald Kirk
9137 S. RIDGELINE BLVD, SUITE 135
HIGHLANDS RANCH
CO
80129
1
1
0
0
Chief Executive Officer
Common Stock
2021-09-21
4
P
0
5000
4.31
A
15500
D
Common Stock
1740000
I
See footnote
Stock Option (Right to Buy)
1.65
2022-09-30
Common Stock
333334
333334
D
Shares held by Coronado V Partners, LLC, of which the reporting person is a member and manager.
The option provides for vesting in five equal annual installments beginning on January 15, 2017.
/s/ Brad Amman as attorney-in-fact for R. Kirk Huntsman
2021-09-22