0001209191-19-042266.txt : 20190716
0001209191-19-042266.hdr.sgml : 20190716
20190716180515
ACCESSION NUMBER: 0001209191-19-042266
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20190712
FILED AS OF DATE: 20190716
DATE AS OF CHANGE: 20190716
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Irwin Dean
CENTRAL INDEX KEY: 0001746687
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38677
FILM NUMBER: 19957897
MAIL ADDRESS:
STREET 1: C/O RA MEDICAL SYSTEMS, INC.
STREET 2: 2070 LAS PALMAS DRIVE
CITY: CARLSBAD
STATE: CA
ZIP: 92011
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Dean Irwin & Melissa Burstein, as Trustees U/T/A June 12, 2017
CENTRAL INDEX KEY: 0001748379
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38677
FILM NUMBER: 19957898
BUSINESS ADDRESS:
STREET 1: C/O RA MEDICAL SYSTEMS, INC.
STREET 2: 2070 LAS PALMAS DRIVE
CITY: CARLSBAD
STATE: CA
ZIP: 92011
BUSINESS PHONE: 760-804-1648
MAIL ADDRESS:
STREET 1: C/O RA MEDICAL SYSTEMS, INC.
STREET 2: 2070 LAS PALMAS DRIVE
CITY: CARLSBAD
STATE: CA
ZIP: 92011
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
2019-07-12
0
0001716621
Ra Medical Systems, Inc.
RMED
0001746687
Irwin Dean
C/O RA MEDICAL SYSTEMS, INC.
2070 LAS PALMAS DRIVE
CARLSBAD
CA
92011
1
1
1
0
See Remarks
0001748379
Dean Irwin & Melissa Burstein, as Trustees U/T/A June 12, 2017
C/O RA MEDICAL SYSTEMS, INC.
2070 LAS PALMAS DRIVE
CARLSBAD
CA
92011
0
0
1
0
Common Stock
2019-07-12
4
S
0
7400
3.2665
D
213812
D
Common Stock
2019-07-12
4
S
0
4400
3.2756
D
128438
I
By Spouse
Common Stock
2803852
I
See Footnote
The sales reported in this Form 4 were effected pursuant to a Rule 10b5-1 trading plans adopted by the reporting person and the reporting person's spouse on September 27, 2018.
The reported price in Column 4 is a weighted average sale price. These shares were sold in multiple transactions at prices ranging from $3.07 to $3.35 per share. The Reporting Person undertakes to provide to the issuer, any security holder of the issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth in this footnote.
Of the reported shares 173,670 shares are represented by Restricted Stock Units.
The reported price in Column 4 is a weighted average sale price. These shares were sold in multiple transactions at prices ranging from $3.06 to $3.35 per share. The Reporting Person undertakes to provide to the issuer, any security holder of the issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth in this footnote.
Of the reported shares 104,202 shares are represented by Restricted Stock Units.
Shares held of record by Dean Irwin & Melissa Burstein, as Trustees U/T/A June 12, 2017, of which Dean Irwin serves as co-trustee.
CEO, Co-President, CTO, and Chairman of Board
/s/ Daniel Horwood, as Attorney-in-Fact, on behalf of Dean Irwin and Dean Irwin & Melissa Burstein, as Trustees U/T/A June 12, 2017
2019-07-16