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