0001209191-21-039047.txt : 20210608
0001209191-21-039047.hdr.sgml : 20210608
20210608200027
ACCESSION NUMBER: 0001209191-21-039047
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210604
FILED AS OF DATE: 20210608
DATE AS OF CHANGE: 20210608
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: COLOMBATTO MARTIN J
CENTRAL INDEX KEY: 0001208236
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38677
FILM NUMBER: 211003645
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Ra Medical Systems, Inc.
CENTRAL INDEX KEY: 0001716621
STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841]
IRS NUMBER: 383661826
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 2070 LAS PALMAS DRIVE
CITY: CARLSBAD
STATE: CA
ZIP: 92011
BUSINESS PHONE: (760) 804-1648
MAIL ADDRESS:
STREET 1: 2070 LAS PALMAS DRIVE
CITY: CARLSBAD
STATE: CA
ZIP: 92011
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2021-06-04
0
0001716621
Ra Medical Systems, Inc.
RMED
0001208236
COLOMBATTO MARTIN J
C/O RA MEDICAL SYSTEMS, INC.
2070 LAS PALMAS DRIVE
CARLSBAD
CA
92011
1
0
0
0
Common Stock
2021-06-04
4
A
0
4000
0.00
A
29439
D
Common Stock
1500
I
See Footnote
Reported shares represents a grant of restricted stock awards (the "RSAs") pursuant to Ra Medical Systems, Inc.'s 2018 Equity Incentive Plan. Each restricted stock award represents a contingent right to receive one share of Ra Medical Systems, Inc. common stock. The RSAs will vest on the earlier of (i) June 4, 2022, or (ii) the day prior to the date of the Stockholder's Annual Meeting next following June 4, 2021, subject to the reporting person's continued service.
Shares held of record by the M Colombatto Trust, for which the reporting person serves as trustee.
/s/ Daniel Horwood, as Attorney-in-Fact
2021-06-08