0000899243-20-029070.txt : 20201022
0000899243-20-029070.hdr.sgml : 20201022
20201022190043
ACCESSION NUMBER: 0000899243-20-029070
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20201020
FILED AS OF DATE: 20201022
DATE AS OF CHANGE: 20201022
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Wu David James
CENTRAL INDEX KEY: 0001827421
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39616
FILM NUMBER: 201255719
MAIL ADDRESS:
STREET 1: 411 FIRST AVENUE SOUTH, SUITE 600
CITY: SEATTLE
STATE: WA
ZIP: 98104
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Eargo, Inc.
CENTRAL INDEX KEY: 0001719395
STANDARD INDUSTRIAL CLASSIFICATION: ORTHOPEDIC, PROSTHETIC & SURGICAL APPLIANCES & SUPPLIES [3842]
IRS NUMBER: 273879804
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 1600 TECHNOLOGY DRIVE
STREET 2: 6TH FLOOR
CITY: SAN JOSE
STATE: CA
ZIP: 95110
BUSINESS PHONE: 650-351-7700
MAIL ADDRESS:
STREET 1: 1600 TECHNOLOGY DRIVE
STREET 2: 6TH FLOOR
CITY: SAN JOSE
STATE: CA
ZIP: 95110
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2020-10-20
0
0001719395
Eargo, Inc.
EAR
0001827421
Wu David James
C/O MAVERON LLC
411 1ST AVENUE SOUTH, SUITE 600
SEATTLE
WA
98104
1
0
0
0
Common Stock
2020-10-20
4
C
0
1438263
A
1441258
I
See Footnote
Common Stock
2020-10-20
4
P
0
111111
18.00
A
1552369
I
See Footnote
Series A Preferred Stock
2020-10-20
4
C
0
135374
0.00
D
Common Stock
265233
0
I
See Footnote
Series B-1 Preferred Stock
2020-10-20
4
C
0
182901
0.00
D
Common Stock
622030
0
I
See Footnote
Series C Preferred Stock
2020-10-20
4
C
0
55428
0.00
D
Common Stock
62008
0
I
See Footnote
Series C-1 Preferred Stock
2020-10-20
4
C
0
445046
0.00
D
Common Stock
461526
0
I
See Footnote
Series D Preferred Stock
2020-10-20
4
C
0
18691
0.00
D
Common Stock
23302
0
I
See Footnote
Series E Preferred Stock
2020-10-20
4
C
0
4164
0.00
D
Common Stock
4164
0
I
See Footnote
The Series A Preferred Stock automatically converted into shares of Common Stock on a 1:1.959283637 basis immediately prior to the completion of the Issuer's initial public offering of Common Stock and had no expiration date.
The Series B-1 Preferred Stock automatically converted into shares of Common Stock on a 1:3.400930233 basis immediately prior to the completion of the Issuer's initial public offering of Common Stock and had no expiration date.
The Series C Preferred Stock automatically converted into shares of Common Stock on a 1:1.118772093 basis immediately prior to the completion of the Issuer's initial public offering of Common Stock and had no expiration date.
The Series C-1 Preferred Stock automatically converted into shares of Common Stock on a 1:1.037033844 basis immediately prior to the completion of the Issuer's initial public offering of Common Stock and had no expiration date.
The Series D Preferred Stock automatically converted into shares of Common Stock on a 1:1.246748888 basis immediately prior to the completion of the Issuer's initial public offering of Common Stock and had no expiration date.
The Series E Preferred Stock automatically converted into shares of Common Stock on a 1:1 basis immediately prior to the completion of the Issuer's initial public offering of Common Stock and had no expiration date.
Consists of 9,067 shares held by Maveron Equity Partners IV, L.P. ("MEP IV"), 989,345 shares held by Maveron Equity Partners V, L.P. ("MEP V"), 293 shares held by Maveron IV Entrepreneurs' Fund, L.P. ("Entrepreneurs Fund IV"), 122,786 shares held by Maveron V Entrepreneurs' Fund, L.P. ("Entrepreneurs Fund V"), 758 shares held by MEP Associates IV, L.P. ("Associates Fund IV") and 319,009 shares held by MEP Associates V, L.P. ("Associates Fund V"). The Reporting Person is a partner at Maveron LLC, which is affiliated with MEP IV, MEP V, Entrepreneurs Fund IV, Entrepreneurs Fund V, Associates Fund IV and Associates Fund V, and disclaims beneficial ownership of all applicable shares except to the extent of his actual pecuniary interest in such shares.
Consists of 9,067 shares held by MEP IV, 1,059,612 shares held MEP V, 293 shares held by Entrepreneurs Fund IV, 131,397 shares held by Entrepreneurs Fund V, 758 shares held by Associates Fund IV and 352,242 shares held by Associates Fund V. The Reporting Person is a partner at Maveron LLC, which is affiliated with MEP IV, MEP V, Entrepreneurs Fund IV, Entrepreneurs Fund V, Associates Fund IV and Associates Fund V, and disclaims beneficial ownership of all applicable shares except to the extent of his actual pecuniary interest in such shares.
Consists of 4,628 shares held by MEP IV, 89,154 shares held by MEP V, 150 shares held by Entrepreneurs Fund IV, 11,068 shares held by Entrepreneurs Fun V, and 29,987 shares held by Associates Fund V. The Reporting Person is a partner at Maveron LLC, which is affiliated with MEP IV, MEP V, Entrepreneurs Fund IV and Associates Fund IV, and disclaims beneficial ownership of all applicable shares except to the extent of his actual pecuniary interest in such shares.
Consists of 125,233 shares held by MEP V, 15,546 shares held by Entrepreneurs Fund V, and 42,122 shares held by Associates Fund V. The Reporting Person is a partner at Maveron LLC, which is affiliated with MEP V, Entrepreneurs Fund V and Associates Fund V, and disclaims beneficial ownership of all applicable shares except to the extent of his actual pecuniary interest in such shares.
Consists of 45,286 shares held by MEP V, 5,598 shares held by Entrepreneurs Fund V, and 4,544 shares held by Associates Fund V. The Reporting Person is a partner at Maveron LLC, which is affiliated with MEP V, Entrepreneurs Fund V and Associates Fund V, and disclaims beneficial ownership of all applicable shares except to the extent of his actual pecuniary interest in such shares.
Consists of 304,723 shares held by MEP V, 37,829 shares held by Entrepreneurs Fund V, and 102,494 shares held by Associates Fund V. The Reporting Person is a partner at Maveron LLC, which is affiliated with MEP V, Entrepreneurs Fund V and Associates Fund V, and disclaims beneficial ownership of all applicable shares except to the extent of his actual pecuniary interest in such shares.
Consists of 13,635 shares held by MEP V, 1,692 shares held by Entrepreneurs Fund V, and 3,364 shares held by Associates Fund V. The Reporting Person is a partner at Maveron LLC, which is affiliated with MEP V, Entrepreneurs Fund V and Associates Fund V, and disclaims beneficial ownership of all applicable shares except to the extent of his actual pecuniary interest in such shares.
Consists of 3,038 shares held by MEP V, 377 shares held by Entrepreneurs Fund V, and 749 shares held by Associates Fund V. The Reporting Person is a partner at Maveron LLC, which is affiliated with MEP V, Entrepreneurs Fund V and Associates Fund V, and disclaims beneficial ownership of all applicable shares except to the extent of his actual pecuniary interest in such shares.
/s/ Christy La Pierre, Attorney-in-Fact for David James Wu
2020-10-22