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