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