0000899243-20-029078.txt : 20201022 0000899243-20-029078.hdr.sgml : 20201022 20201022194102 ACCESSION NUMBER: 0000899243-20-029078 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: Bisgaard Peter CENTRAL INDEX KEY: 0001606387 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39616 FILM NUMBER: 201255767 MAIL ADDRESS: STREET 1: 11804 NORTH CREEK PARKWAY SOUTH CITY: BOTHELL STATE: WA ZIP: 98011 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 doc4.xml FORM 4 SUBMISSION X0306 4 2020-10-20 0 0001719395 Eargo, Inc. EAR 0001606387 Bisgaard Peter C/O EARGO, INC. 1600 TECHNOLOGY DRIVE, 6TH FLOOR SAN JOSE CA 95110 1 0 0 0 Common Stock 2020-10-20 4 C 0 41969 A 41969 D Common Stock 2020-10-20 4 C 0 2664502 A 2664502 I See footnote Common Stock 2020-10-20 4 P 0 222222 18.00 A 2886724 I See footnotes Series C Preferred Stock 2020-10-20 4 C 0 11086 0.00 D Common Stock 12402 0 D Series C Preferred Stock 2020-10-20 4 C 0 1330361 0.00 D Common Stock 1488369 0 I See Footnote Series D Preferred Stock 2020-10-20 4 C 0 3738 0.00 D Common Stock 4660 0 D Series D Preferred Stock 2020-10-20 4 C 0 261701 0.00 D Common Stock 326275 0 I See Footnote Series E Preferred Stock 2020-10-20 4 C 0 24907 0.00 D Common Stock 24907 0 D Series E Preferred Stock 2020-10-20 4 C 0 849858 0.00 D Common Stock 849858 0 I See Footnote The Series C Preferred Stock automatically converted into shares of Common Stock on a 1:1.118772093 basis immediately prior to the completion of the Issuer's initial public offering of Common Stock and had no expiration date. The Series D Preferred Stock automatically converted into shares of Common Stock on a 1:1.246748888 basis immediately prior to the completion of the Issuer's initial public offering of Common Stock and had no expiration date. The Series E Preferred Stock automatically converted into shares of Common Stock on a 1:1 basis immediately prior to the completion of the Issuer's initial public offering of Common Stock and had no expiration date. These shares are held directly by Pivotal Alpha Limited ("Pivotal"). Investment and voting decisions by Pivotal are made jointly by the executive committee of Nan Fung Group Holdings Limited (the "NFGHL Executive Committee"), which indirectly owns Pivotal. Kam Chung Leung, Frank Kai Shui Seto, Vincent Sai Sing Cheung, Pui Kuen Cheung, Kin Ho Kwok, Vanessa Tih Lin Cheung, Meng Gao and Chun Wai Nelson Tang are each on the NFGHL Executive Committee. Mr. Bisgaard is a Managing Partner of Pivotal Bioventure Partners LLC, which is affiliated with Pivotal, and disclaims beneficial ownership of all applicable shares except to the extent of his actual pecuniary interest in such shares. Includes 2,664,502 shares held directly by Pivotal Alpha Limited ("Pivotal") and 222,222 shares held directly by Permwell Management Limited ("Permwell"). Investment and voting decisions by Pivotal are made jointly by the executive committee of Nan Fung Group Holdings Limited (the "NFGHL Executive Committee"), which indirectly owns Pivotal and Permwell. Investment decisions by Permwell are generally made by Nan Fung Trinity (HK) Limited, which is indirectly owned by Nan Fung Group Holdings Limited. Voting decisions by Permwell are made by the NFGHL Executive Committee. (Continued from footnote 5) Kam Chung Leung, Frank Kai Shui Seto, Vincent Sai Sing Cheung, Pui Kuen Cheung, Kin Ho Kwok, Vanessa Tih Lin Cheung, Meng Gao and Chun Wai Nelson Tang are each on the NFGHL Executive Committee. Mr. Bisgaard is a Managing Partner of Pivotal Bioventure Partners LLC, which is affiliated with Pivotal and Permwell, and disclaims beneficial ownership of all applicable shares except to the extent of his actual pecuniary interest in such shares. /s/ Christy La Pierre, Attorney-in-Fact for Peter Bisgaard 2020-10-22