0001104659-20-134757.txt : 20201211
0001104659-20-134757.hdr.sgml : 20201211
20201211160230
ACCESSION NUMBER: 0001104659-20-134757
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20201209
FILED AS OF DATE: 20201211
DATE AS OF CHANGE: 20201211
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: SMITH THOMAS W
CENTRAL INDEX KEY: 0000926688
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38740
FILM NUMBER: 201383596
MAIL ADDRESS:
STREET 1: 2200 BUTTS ROAD
STREET 2: SUITE 320
CITY: BOCA RATON
STATE: FL
ZIP: 33431
FORMER NAME:
FORMER CONFORMED NAME: THOMAS W SMITH
DATE OF NAME CHANGE: 19940713
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: VAPOTHERM INC
CENTRAL INDEX KEY: 0001253176
STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841]
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 100 DOMAIN DRIVE
CITY: EXETER
STATE: NH
ZIP: 03833
BUSINESS PHONE: 603-658-0411
MAIL ADDRESS:
STREET 1: 100 DOMAIN DRIVE
CITY: EXETER
STATE: NH
ZIP: 03833
4
1
tm2038308-1_4.xml
OWNERSHIP DOCUMENT
X0306
4
2020-12-09
0
0001253176
VAPOTHERM INC
VAPO
0000926688
SMITH THOMAS W
2200 BUTTS ROAD
SUITE 320
BOCA RATON
FL
33431
0
0
1
1
Member of Section 13(d) Group
Common Stock
2020-12-09
4
P
0
8000
27.1394
A
139500
I
By Thomas W. Smith Family Accounts
Common Stock
450000
I
By Ridgeview Smith Investments LLC
Common Stock
86447
I
By Prescott Investors Profit Sharing Trust
These shares are owned directly by investment accounts established for the benefit of certain family members of Thomas W. Smith. The inclusion of these shares in this report shall not be deemed an admission of beneficial ownership for purposes of Section 16 or any other purpose and Mr. Smith disclaims beneficial ownership of these shares except to the extent of his pecuniary interest therein.
These shares are owned directly by Ridgeview Smith Investments LLC ("Ridgeview"), a limited liability company established by Mr. Smith for the benefit of his family and are beneficially owned indirectly by Mr. Smith as trustee of a revocable trust he established for the benefit of his family and which is the sole member of Ridgeview. Mr. Smith disclaims beneficial ownership of these shares in excess of his pecuniary interest under Rule 16a-1(a)(2)(iii). The address of Ridgeview is 2200 Butts Road, Suite 320, Boca Raton, FL 33431.
These shares are owned directly by the Prescott Investors Profit Sharing Trust (the "Trust"), an employee profit-sharing plan for which Mr. Smith serves as a trustee. The inclusion of these shares in this report shall not be deemed an admission of beneficial ownership for purposes of Section 16 or any other purpose and Mr. Smith disclaims beneficial ownership of these shares under Rule 16a-8(b)(1). The address of the Trust is 2200 Butts Road, Suite 320, Boca Raton, FL 33431.
The filing of this report shall not be deemed to be an admission that the Reporting Person is a member of a "group" within the meaning of Section 13(d)(3) of the Securities Exchange Act of 1934, as amended. The Reporting Person disclaims beneficial ownership of the shares included in this report except to the extent of his pecuniary interest in such shares.
/s/ Thomas W. Smith
2020-12-11