0001828795-20-000003.txt : 20201022 0001828795-20-000003.hdr.sgml : 20201022 20201022092301 ACCESSION NUMBER: 0001828795-20-000003 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: Future Fund Board of Guardians CENTRAL INDEX KEY: 0001505790 STATE OF INCORPORATION: C3 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39616 FILM NUMBER: 201251913 BUSINESS ADDRESS: STREET 1: LEVEL 43, 120 COLLINS STREET CITY: MELBOURNE STATE: C3 ZIP: VIC 3000 BUSINESS PHONE: 61 03 8656 6400 MAIL ADDRESS: STREET 1: LEVEL 43, 120 COLLINS STREET CITY: MELBOURNE STATE: C3 ZIP: VIC 3000 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Future Fund Investment Co No. 4 Pty Ltd CENTRAL INDEX KEY: 0001828795 STATE OF INCORPORATION: C3 FISCAL YEAR END: 0630 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39616 FILM NUMBER: 201251914 BUSINESS ADDRESS: STREET 1: LEVEL 42 STREET 2: 120 COLLINS STREET CITY: MELBOURNE STATE: C3 ZIP: VIC 3000 BUSINESS PHONE: 61 3 8656 6400 MAIL ADDRESS: STREET 1: LEVEL 42 STREET 2: 120 COLLINS STREET CITY: MELBOURNE STATE: C3 ZIP: VIC 3000 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 edgar.xml PRIMARY DOCUMENT X0306 4 2020-10-20 0001719395 Eargo, Inc. EAR 0001505790 Future Fund Board of Guardians LEVEL 42, 120 COLLINS STREET MELBOURNE C3 3000 AUSTRALIA 0 0 1 0 0001828795 Future Fund Investment Co No. 4 Pty Ltd LEVEL 42, 120 COLLINS STREET MELBOURNE C3 3000 AUSTRALIA 0 0 1 0 Common Stock 2020-10-20 4 C 0 3690481 A 3690481 I By subsidiary Series D convertible preferred stock 2020-10-20 4 C 0 2617018 D Common Stock 3262764 0 I By subsidiary Series E convertible preferred stock 2020-10-20 4 C 0 427717 D Common Stock 427717 0 I By Subsidiary Upon the completion of the Issuer's initial public offering ("IPO"), each share of Series D convertible preferred stock mandatorily converted into 1.246748888 shares of the Issuer's common stock. Upon the completion of the Issuer's IPO, each share of Series E convertible preferred stock mandatorily converted into shares of the Issuer's common stock on a 1:1 basis. These securities are held of record by The Northern Trust Company in its capacity as custodian for Future Fund Investment Company No. 4 Pty Ltd. Future Fund Investment Company No. 4 Pty Ltd is a wholly owned subsidiary of Future Fund Board of Guardians and, accordingly, Future Fund Board of Guardians may be deemed to share beneficial ownership of the securities beneficially held by Future Fund Investment Company No. 4 Pty Ltd Kylie Yong, Authorized Signatory for Future Fund Board of Guardians 2020-10-22 Paul Mann, Authorized Signatory for Future Fund Investment Company No. 4 Pty Ltd 2020-10-22