0001548538-20-000010.txt : 20200527 0001548538-20-000010.hdr.sgml : 20200527 20200527205645 ACCESSION NUMBER: 0001548538-20-000010 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20200527 FILED AS OF DATE: 20200527 DATE AS OF CHANGE: 20200527 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Presidio Management Group X LLC CENTRAL INDEX KEY: 0001602744 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39293 FILM NUMBER: 20916750 BUSINESS ADDRESS: STREET 1: 2735 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: 650-854-9080 MAIL ADDRESS: STREET 1: 2735 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: US VENTURE PARTNERS X LP CENTRAL INDEX KEY: 0001440514 STATE OF INCORPORATION: DE FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39293 FILM NUMBER: 20916751 BUSINESS ADDRESS: STREET 1: 2735 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: 650-854-9080 MAIL ADDRESS: STREET 1: 2735 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: USVP X AFFILIATES LP CENTRAL INDEX KEY: 0001453359 STATE OF INCORPORATION: DE FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39293 FILM NUMBER: 20916752 BUSINESS ADDRESS: STREET 1: 2735 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: 650-854-9080 MAIL ADDRESS: STREET 1: 2735 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: FEDERMAN IRWIN CENTRAL INDEX KEY: 0001192391 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39293 FILM NUMBER: 20916753 MAIL ADDRESS: STREET 1: 2735 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: KRAUSZ STEVEN M CENTRAL INDEX KEY: 0001190636 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39293 FILM NUMBER: 20916754 MAIL ADDRESS: STREET 1: 2735 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Lewis Richard W. CENTRAL INDEX KEY: 0001534399 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39293 FILM NUMBER: 20916755 MAIL ADDRESS: STREET 1: US VENTURE PARTNERS STREET 2: 2735 SAND HILL ROAD CITY: MELO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Matteucci Paul A CENTRAL INDEX KEY: 0001370817 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39293 FILM NUMBER: 20916756 MAIL ADDRESS: STREET 1: 2735 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Tansey Casey M CENTRAL INDEX KEY: 0001474322 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39293 FILM NUMBER: 20916757 MAIL ADDRESS: STREET 1: 2735 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Inari Medical, Inc. CENTRAL INDEX KEY: 0001531048 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 452902923 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 9 PARKER, SUITE 100 CITY: IRVINE STATE: CA ZIP: 92618 BUSINESS PHONE: 949-923-4747 MAIL ADDRESS: STREET 1: 9 PARKER, SUITE 100 CITY: IRVINE STATE: CA ZIP: 92618 FORMER COMPANY: FORMER CONFORMED NAME: Inceptus Newco1 Inc. DATE OF NAME CHANGE: 20110923 4 1 edgar.xml PRIMARY DOCUMENT X0306 4 2020-05-27 0001531048 Inari Medical, Inc. NARI 0001602744 Presidio Management Group X LLC 1460 EL CAMINO REAL, SUITE 100 MENLO PARK CA 94025 0 0 1 0 0001440514 US VENTURE PARTNERS X LP 1460 EL CAMINO REAL, SUITE 100 MENLO PARK CA 94025 0 0 1 0 0001453359 USVP X AFFILIATES LP 1460 EL CAMINO REAL, SUITE 100 MENLO PARK CA 94025 0 0 1 0 0001192391 FEDERMAN IRWIN 1460 EL CAMINO REAL, SUITE 100 MENLO PARK CA 94025 0 0 1 0 0001190636 KRAUSZ STEVEN M 1460 EL CAMINO REAL, SUITE 100 MENLO PARK CA 94025 0 0 1 0 0001534399 Lewis Richard W. 1460 EL CAMINO REAL, SUITE 100 MENLO PARK CA 94025 0 0 1 0 0001370817 Matteucci Paul A 1460 EL CAMINO REAL, SUITE 100 MENLO PARK CA 94025 0 0 1 0 0001474322 Tansey Casey M 1460 EL CAMINO REAL, SUITE 100 MENLO PARK CA 94025 0 0 1 0 Common Stock 2020-05-27 4 C 0 2307142 A 2307142 I Directly owned by USVP X Common Stock 2020-05-27 4 C 0 2899876 A 5207018 I Directly owned by USVP X Common Stock 2020-05-27 4 C 0 2278331 A 7485349 I Directly owned by USVP X Common Stock 2020-05-27 4 C 0 73809 A 73809 I Directly owned by AFF X Common Stock 2020-05-27 4 C 0 92771 A 166580 I Directly owned by AFF X Common Stock 2020-05-27 4 C 0 72887 A 239467 I Directly owned by AFF X Common Stock 2020-05-27 4 P 0 97962 19.00 A 97962 I Directly owned by Casey Tansey Series A Preferred Stock 2020-05-27 4 C 0 2307142 0 D Common Stock 2307142 0 I Directly owned by USVP X Series A Preferred Stock 2020-05-27 4 C 0 73809 0 D Common Stock 73809 0 I Directly owned by AFF X Series B Preferred Stock 2020-05-27 4 C 0 2899876 0 D Common Stock 2899876 0 I Directly owned by USVP X Series B Preferred Stock 2020-05-27 4 C 0 92771 0 D Common Stock 92771 0 I Directly owned by AFF X Series C Preferred Stock 2020-05-27 4 C 0 2278331 0 D Common Stock 2278331 0 I Directly owned by USVP X Series C Preferred Stock 2020-05-27 4 C 0 72887 0 D Common Stock 72887 0 I Directly owned by AFF X Each share of the Issuer's preferred stock is convertible on a one-to-one basis into shares of the Issuer's common stock at the holder's election and has no expiration date. The preferred stock will automatically convert into common stock upon the closing of the Issuer's initial public offering. The reported securities are owned directly by each of U.S. Venture Partners X, L.P. ("USVP X") and USVP X Affiliates Fund, L.P. ("AFF X") (together, the "USVP X Funds"). Presidio Management Group X, L.L.C. ("PMG X") is the general partner of each of the USVP X Funds and may be deemed to have sole voting and dispositive power over the reported securities held by the USVP X Funds. Jonathan D. Root, a director of the issuer, Irwin Federman, Steven Krausz, Richard Lewis, Paul Matteucci and Casey Tansey are the managing members of PMG X, who may be deemed to share voting and dispositive power over the reported securities held by the USVP X Funds. Such persons and entities disclaim beneficial ownership of the reported securities held by the USVP X Funds, except to the extent of any pecuniary interest therein Presidio Management Group X, L.L.C., By: /s/ Dale Holladay - Attorney in Fact 2020-05-27 U.S. Venture Partners X, L.P, By: /s/ Dale Holladay - Attorney in Fact 2020-05-27 USVP X Affiliates, L.P, By: /s/ Dale Holladay - Attorney in Fact 2020-05-27 Irwin Federman, By: /s/ Dale Holladay - Attorney in Fact 2020-05-27 Steven M Krausz, By: /s/ Dale Holladay - Attorney in Fact 2020-05-27 Richard W. Lewis, By: /s/ Dale Holladay - Attorney in Fact 2020-05-27 Paul Matteucci, By: /s/ Dale Holladay - Attorney in Fact 2020-05-27 Casey M. Tansey, By: /s/ Dale Holladay - Attorney in Fact 2020-05-27