0001104659-21-049767.txt : 20210413 0001104659-21-049767.hdr.sgml : 20210413 20210413161646 ACCESSION NUMBER: 0001104659-21-049767 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210409 FILED AS OF DATE: 20210413 DATE AS OF CHANGE: 20210413 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: NELSON MARILYN C CENTRAL INDEX KEY: 0001199894 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38468 FILM NUMBER: 21823282 MAIL ADDRESS: STREET 1: C/O EXXON MOBIL CORP STREET 2: 5959 LAS COLINAS BLVD. CITY: IRVING STATE: TX ZIP: 75039-2298 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Inspire Medical Systems, Inc. CENTRAL INDEX KEY: 0001609550 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 261377674 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 5500 WAYZATA BLVD STREET 2: SUITE 1600 CITY: GOLDEN VALLEY STATE: MN ZIP: 55416 BUSINESS PHONE: 763-957-5037 MAIL ADDRESS: STREET 1: 5500 WAYZATA BLVD STREET 2: SUITE 1600 CITY: GOLDEN VALLEY STATE: MN ZIP: 55416 4 1 tm2112723-4_4seq1.xml OWNERSHIP DOCUMENT X0306 4 2021-04-09 0 0001609550 Inspire Medical Systems, Inc. INSP 0001199894 NELSON MARILYN C C/O INSPIRE MEDICAL SYSTEMS, INC. 5500 WAYZATA BLVD., SUITE 1600 GOLDEN VALLEY MN 55416 1 0 0 0 Common Stock 2021-04-09 4 A 0 94 218.45 A 3389 D Common Stock 126236 I See Footnote Represents shares of common stock received in lieu of cash fees pursuant to the Company's Non-Employee Director Compensation Policy. Shares held by GDN Holdings, LLC, of which the Reporting Person is the managing member. /s/ Richard Buchholz, as Attorney-in-Fact for Marilyn Carlson Nelson 2021-04-13