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