0001209191-19-059366.txt : 20191205
0001209191-19-059366.hdr.sgml : 20191205
20191205181707
ACCESSION NUMBER: 0001209191-19-059366
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20191203
FILED AS OF DATE: 20191205
DATE AS OF CHANGE: 20191205
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Horwood Daniel
CENTRAL INDEX KEY: 0001756566
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38677
FILM NUMBER: 191271350
MAIL ADDRESS:
STREET 1: C/O RA MEDICAL SYTEMS, 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
2019-12-03
0
0001716621
Ra Medical Systems, Inc.
RMED
0001756566
Horwood Daniel
C/O RA MEDICAL SYSTEMS, INC.
2070 LAS PALMAS DR.
CARLSBAD
CA
92011
0
1
0
0
General Counsel
Stock Option (Right to Buy)
1.22
2019-12-03
4
A
0
139052
0.00
A
2029-12-03
Common Stock
139052
139052
D
1/12 of the total shares subject to the option shall vest every month after December 3, 2019, such that all shares subject to the option shall be fully vested on December 3, 2020, subject to the Reporting Person continuing to be a "Service Provider" (as defined in the Company's 2018 Equity Incentive Plan) through each vesting date.
/s/ Daniel Horwood
2019-12-05