0000899243-16-032257.txt : 20161025 0000899243-16-032257.hdr.sgml : 20161025 20161025132210 ACCESSION NUMBER: 0000899243-16-032257 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20161025 FILED AS OF DATE: 20161025 DATE AS OF CHANGE: 20161025 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: iRhythm Technologies, Inc. CENTRAL INDEX KEY: 0001388658 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 208149544 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 650 TOWNSEND STREET STREET 2: SUITE 380 CITY: San Francisco STATE: CA ZIP: 94103 BUSINESS PHONE: 415-632-5700 MAIL ADDRESS: STREET 1: 650 TOWNSEND STREET STREET 2: SUITE 380 CITY: San Francisco STATE: CA ZIP: 94103 FORMER COMPANY: FORMER CONFORMED NAME: IRhythm Technologies, Inc. DATE OF NAME CHANGE: 20110429 FORMER COMPANY: FORMER CONFORMED NAME: IRhythm Technologies Inc DATE OF NAME CHANGE: 20070201 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: New Leaf Venture Associates II, L.P. CENTRAL INDEX KEY: 0001441858 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37918 FILM NUMBER: 161949978 BUSINESS ADDRESS: STREET 1: TIMES SQUARE TOWER STREET 2: 7 TIMES SQUARE, SUITE 3502 CITY: NEW YORK STATE: NY ZIP: 10036 BUSINESS PHONE: 646 871-6400 MAIL ADDRESS: STREET 1: TIMES SQUARE TOWER STREET 2: 7 TIMES SQUARE, SUITE 3502 CITY: NEW YORK STATE: NY ZIP: 10036 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: HUNT RONALD CENTRAL INDEX KEY: 0001247851 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37918 FILM NUMBER: 161949980 MAIL ADDRESS: STREET 1: C/O CREDIT SUISSE 1ST BOSTON PRV EQY STREET 2: 11 MADISON AVENUE CITY: NEW YORK STATE: NY ZIP: 10010 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Delagardelle Jeani CENTRAL INDEX KEY: 0001441563 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37918 FILM NUMBER: 161949981 MAIL ADDRESS: STREET 1: C/O NEW LEAF VENTURE PARTNERS, L.L.C. STREET 2: 2500 SAND HILL ROAD, SUITE 203 CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: New Leaf Ventures II, L.P. CENTRAL INDEX KEY: 0001441439 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37918 FILM NUMBER: 161949982 BUSINESS ADDRESS: STREET 1: TIMES SQUARE TOWER STREET 2: 7 TIMES SQUARE, SUITE 3502 CITY: NEW YORK STATE: NY ZIP: 10036 BUSINESS PHONE: (646) 871-6400 MAIL ADDRESS: STREET 1: TIMES SQUARE TOWER STREET 2: 7 TIMES SQUARE, SUITE 3502 CITY: NEW YORK STATE: NY ZIP: 10036 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: New Leaf Venture Management II, L.L.C. CENTRAL INDEX KEY: 0001441857 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37918 FILM NUMBER: 161949984 BUSINESS ADDRESS: STREET 1: TIMES SQUARE TOWER STREET 2: 7 TIMES SQUARE, SUITE 3502 CITY: NEW YORK STATE: NY ZIP: 10036 BUSINESS PHONE: 646 871-6400 MAIL ADDRESS: STREET 1: TIMES SQUARE TOWER STREET 2: 7 TIMES SQUARE, SUITE 3502 CITY: NEW YORK STATE: NY ZIP: 10036 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Ratcliffe Liam CENTRAL INDEX KEY: 0001547100 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37918 FILM NUMBER: 161949979 MAIL ADDRESS: STREET 1: C/O NEW LEAF VENTURE PARTNERS STREET 2: 7 TIMES SQUARE - SUITE 3502 CITY: NEW YORK STATE: NY ZIP: 10036 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Chambon Philippe O. CENTRAL INDEX KEY: 0001192212 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37918 FILM NUMBER: 161949983 MAIL ADDRESS: STREET 1: C/O NEW LEAF VENTURE PARTNERS STREET 2: 7 TIMES SQUARE, SUITE 3502 CITY: NEW YORK STATE: NY ZIP: 10036 FORMER NAME: FORMER CONFORMED NAME: CHAMBON PHILIPPE DATE OF NAME CHANGE: 20020924 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2016-10-25 1 0001388658 iRhythm Technologies, Inc. IRTC 0001441439 New Leaf Ventures II, L.P. C/O NEW LEAF VENTURE PARTNERS 7 TIMES SQUARE, SUITE 3502 NEW YORK NY 10036 0 0 1 0 0001441563 Delagardelle Jeani C/O NEW LEAF VENTURE PARTNERS, 1200 PARK PLACE, SUITE 300 SAN MATEO CA 94403 0 0 1 0 0001247851 HUNT RONALD C/O NEW LEAF VENTURE PARTNERS, 7 TIMES SQUARE, SUITE 3502 NEW YORK NY 10036 0 0 1 0 0001547100 Ratcliffe Liam C/O NEW LEAF VENTURE PARTNERS, 7 TIMES SQUARE, SUITE 3502 NEW YORK NY 10036 0 0 1 0 0001441858 New Leaf Venture Associates II, L.P. C/O NEW LEAF VENTURE PARTNERS, 7 TIMES SQUARE, SUITE 3502 NEW YORK NY 10036 0 0 1 0 0001441857 New Leaf Venture Management II, L.L.C. C/O NEW LEAF VENTURE PARTNERS, 7 TIMES SQUARE, SUITE 3502 NEW YORK NY 10036 0 0 1 0 0001192212 Chambon Philippe O. C/O NEW LEAF VENTURE PARTNERS, 7 TIMES SQUARE, SUITE 3502 NEW YORK NY 10036 0 0 1 0 Common Stock 2016-10-25 4 C 0 1716589 A 1716589 D Common Stock 2016-10-25 4 P 0 25000 17.00 A 1741589 D Series C Convertible Preferred Stock 2016-10-25 4 C 0 610136 0.00 D Common Stock 1370887 0 D Series D Convertible Preferred Stock 2016-10-25 4 C 0 190154 0.00 D Common Stock 190154 0 D Series E Convertible Preferred Stock 2016-10-25 4 C 0 155548 0.00 D Common Stock 155548 0 D Series D Preferred Stock Warrant (Right to Buy) 0.001 2016-10-25 4 C 0 72389 0.00 D 2012-11-01 2019-11-01 Common Stock 72389 0 D The Series C Convertible Preferred Stock converted into Common Stock on a 2.24685484-for-1 basis and had no expiration date. The Series D Convertible Preferred Stock converted into Common Stock on a 1-for-1 basis and had no expiration date. The Series E Convertible Preferred Stock converted into Common Stock on a 1-for-1 basis and had no expiration date. Reflects 5.882698 for 1 reverse stock split which became effective on October 5, 2016. Represents shares directly beneficially owned by New Leaf Ventures II, L.P. ("NLV II"). New Leaf Venture Associates II, L.P. ("NLV Associates II") is the general partner of NLV II and New Leaf Venture Management II, L.L.C. ("NLV Management II") is the general partner of NLV Associates II. Philippe O. Chambon, Jeani Delagardelle, Ronald Hunt, Vijay Lathi and Liam Ratcliffe are the individual managers of NLV Management II (the "Individual Managers"). NLV Associates II and NLV Management II disclaim beneficial ownership of such shares, except to the extent of their pecuniary interest therein. Vijay Lathi is a director of the Issuer and, accordingly, files separate Section 16 reports. As one of five individual managers, each of the Individual Managers disclaims beneficial ownership over the shares reported herein, and in all events disclaims pecuniary interest except to the extent of his or her economic interest. /s/ Craig L. Slutzkin, attorney-in-fact, Craig L. Slutzkin, attorney-in-fact for New Leaf Venture Management II, L.L.C., the sole general partner of New Leaf Venture Associates II, L.P., the sole general partner of New Leaf Ventures II, L.P. 2016-10-25 /s/ Craig L. Slutzkin, attorney-in-fact, Craig L. Slutzkin, attorney-in-fact for New Leaf Venture Management II, L.L.C., the sole general partner of New Leaf Venture Associates II, L.P. 2016-10-25 /s/ Craig L. Slutzkin, attorney-in-fact, Craig L. Slutzkin, attorney-in-fact for New Leaf Venture Management II, L.L.C. 2016-10-25 /s/ Craig L. Slutzkin, attorney-in-fact, Craig L. Slutzkin, attorney-in-fact for Philippe O. Chambon 2016-10-25 /s/ Craig L. Slutzkin, attorney-in-fact, Craig L. Slutzkin, attorney-in-fact for Jeani Delagardelle 2016-10-25 /s/ Craig L. Slutzkin, attorney-in-fact, Craig L. Slutzkin, attorney-in-fact for Ronald M. Hunt 2016-10-25 /s/ Craig L. Slutzkin, attorney-in-fact, Craig L. Slutzkin, attorney-in-fact for Liam Ratcliffe 2016-10-25 EX-99 2 attachment1.htm EX-99 DOCUMENT

Exhibit 99


Form 3 Joint Filer Information

Name:  New Leaf Venture Associates II, L.P.

Address:  c/o New Leaf Venture Partners, 7 Times Square, Suite 3502
     New York, NY 10036

Designated Filer:  New Leaf Ventures II, L.P.

Issuer & Ticker Symbol:  iRhythm Technologies, Inc. (IRTC)

Date of Event Requiring Statement:  October 25, 2016

Signature:  /s/ Craig L. Slutzkin, attorney-in-fact, New Leaf Venture
     Associates II, L.P., as general partner of New Leaf Ventures II, L.P.


Name:  New Leaf Venture Management II, L.L. C.

Address:  c/o New Leaf Venture Partners, 7 Times Square, Suite 3502
     New York, NY 10036

Designated Filer:  New Leaf Ventures II, L.P.

Issuer & Ticker Symbol:  iRhythm Technologies, Inc. (IRTC)

Date of Event Requiring Statement:  October 25, 2016

Signature:  /s/ Craig L. Slutzkin, attorney-in-fact, New Leaf Venture
     Management II, L.L.C, as general partner of  New Leaf Venture
     Associates II, L.P


Name:  Philippe O. Chambon

Address:  c/o New Leaf Venture Partners, 7 Times Square, Suite 3502
      New York, NY 10036

Designated Filer:  New Leaf Ventures II, L.P.

Issuer & Ticker Symbol:  iRhythm Technologies, Inc. (IRTC)

Date of Event Requiring Statement:  October 25, 2016

Signature:  /s/ Craig L. Slutzkin, attorney-in-fact on behalf of
     Philippe O. Chambon, as Member of New Leaf Venture Management II, L.L.C


Name:  Jeani Delagardelle

Address:  c/o New Leaf Venture Partners, 1200 Park Place, Suite 300
     San Mateo, CA  94403

Designated Filer:  New Leaf Ventures II, L.P.

Issuer & Ticker Symbol:  iRhythm Technologies, Inc. (IRTC)

Date of Event Requiring Statement:  October 25, 2016

Signature:  /s/ Craig L. Slutzkin, attorney-in-fact on behalf of
     Jeani Delagardelle, as Member of New Leaf Venture Management II, L.L.C


Name:  Ronald M. Hunt

Address:  c/o New Leaf Venture Partners, 7 Times Square, Suite 3502
     New York, NY 10036

Designated Filer:  New Leaf Ventures II, L.P.

Issuer & Ticker Symbol:  iRhythm Technologies, Inc. (IRTC)

Date of Event Requiring Statement:  October 25, 2016

Signature:  /s/ Craig L. Slutzkin, attorney-in-fact on behalf of Ronald M. Hunt,
     as Member of New Leaf Venture Management II, L.L.C


Name:  Liam Ratcliffe

Address:  c/o New Leaf Venture Partners, 7 Times Square, Suite 3502
     New York, NY 10036

Designated Filer:  New Leaf Ventures II, L.P.

Issuer & Ticker Symbol:  iRhythm Technologies, Inc. (IRTC)

Date of Event Requiring Statement:  October 25, 2016

Signature:  /s/ Craig L. Slutzkin, attorney-in-fact on behalf of Liam Ratcliffe,
     as Member of New Leaf Venture Management II, L.L.C