0000950103-20-015360.txt : 20200805 0000950103-20-015360.hdr.sgml : 20200805 20200805203310 ACCESSION NUMBER: 0000950103-20-015360 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20200805 FILED AS OF DATE: 20200805 DATE AS OF CHANGE: 20200805 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Burgess Vincent J CENTRAL INDEX KEY: 0001365408 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39430 FILM NUMBER: 201079409 MAIL ADDRESS: STREET 1: 2210 FARADAY AVE #100 CITY: CARLSBAD STATE: CA ZIP: 92008 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Acutus Medical, Inc. CENTRAL INDEX KEY: 0001522860 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 451306615 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 2210 FARADAY AVE STREET 2: SUITE 100 CITY: CARLSBAD STATE: CA ZIP: 92008 BUSINESS PHONE: 442-232-6080 MAIL ADDRESS: STREET 1: 2210 FARADAY AVE STREET 2: SUITE 100 CITY: CARLSBAD STATE: CA ZIP: 92008 3 1 dp133954_3-burgess.xml X0206 3 2020-08-05 0 0001522860 Acutus Medical, Inc. AFIB 0001365408 Burgess Vincent J C/O ACUTUS MEDICAL, INC. 2210 FARADAY AVE., SUITE 100 CARLSBAD CA 92008 1 1 0 0 Chief Executive Officer Stock Options (Right to Buy) 4.08 2023-09-19 Common Stock 35993 D Stock Options (Right to Buy) 8.07 2027-09-22 Common Stock 28946 D Stock Options (Right to Buy) 10.31 2028-10-17 Common Stock 362975 D Stock Options (Right to Buy) 14.81 2030-03-04 Common Stock 410395 D This option vests over four years from July 1, 2013, with 1/4 vesting on the first anniversary of the vesting commencement date, and the remainder vesting in 36 equal monthly installments, subject to continued service through each such vesting date This option vests over four years from September 19, 2017, with 1/4 vesting on the first anniversary of the vesting commencement date, and the remainder vesting in 36 equal monthly installments, subject to continued service through each such vesting date This option vests over four years from January 1, 2018, in 16 equal quarterly installments, subject to continued service through each such vesting date This option vests over four years from October 14, 2019, vesting in 48 equal monthly installments, subject to continued service through each such vesting date Exhibit List - Exhibit 24 - Power of Attorney /s/ Charlie Piscitello as attorney-in-fact for Vincent J. Burgess 2020-08-05 EX-24 2 dp133954_ex24.htm EXHIBIT 24

Exhibit 24

 

 

POWER OF ATTORNEY

 

Know all by these presents, that the undersigned hereby constitutes and appoints each of Tom Sohn, Charlie Piscitello and Yolanda Blasing as the undersigned’s true and lawful attorneys-in-fact to:

 

(1)execute for and on behalf of the undersigned, in the undersigned’s capacity as a reporting person pursuant to Section 16 of the Securities Exchange Act of 1934, as amended (the “Exchange Act”), and the rules thereunder of Acutus Medical, Inc. (the “Company”), Forms 3, 4 and 5, including any amendments thereto, in accordance with Section 16(a) of the Exchange Act;

 

(2)do and perform any and all acts for and on behalf of the undersigned which may be necessary or desirable to complete and execute any such Form 3, 4 or 5, complete and execute any amendment or amendments thereto and timely file such form with the United States Securities and Exchange Commission and the applicable stock exchange or similar authority; and

 

(3)take any other action of any type whatsoever in connection with the foregoing which, in the opinion of any of such attorneys-in-fact, may be of benefit to, in the best interest of, or legally required by, the undersigned, it being understood that the documents executed by any of such attorneys-in-fact on behalf of the undersigned pursuant to this Power of Attorney shall be in such form and shall contain such terms and conditions as any of such attorneys-in-fact may approve in the discretion of any of such attorneys-in-fact.

 

The undersigned hereby grants to each such attorney-in-fact full power and authority to do and perform any and every act and thing whatsoever requisite, necessary, or proper to be done in the exercise of any of the rights and powers herein granted, as fully to all intents and purposes as the undersigned might or could do if personally present, with full power of substitution or revocation, hereby ratifying and confirming all that any of such attorneys-in-fact, or the substitute or substitutes of any of such attorneys-in-fact, shall lawfully do or cause to be done by virtue of this Power of Attorney and the rights and powers herein granted. The undersigned acknowledges that the foregoing attorneys-in-fact, in serving in such capacity at the request of the undersigned, are not assuming, nor is the Company assuming, any of the undersigned’s responsibilities to comply with Section 16 of the Exchange Act.

 

This Power of Attorney shall remain in full force and effect until the undersigned is no longer required to file Forms 3, 4 and 5 with respect to the undersigned’s holdings of and transactions in securities issued by the Company, unless earlier revoked by the undersigned in a signed writing delivered to the foregoing attorneys-in-fact.

 

IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be executed as of this 30th day of July, 2020.

 

 

Signature: /s/ Vincent J. Burgess  
Print Name: Vincent J. Burgess