0001548538-21-000017.txt : 20210318 0001548538-21-000017.hdr.sgml : 20210318 20210318183829 ACCESSION NUMBER: 0001548538-21-000017 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210316 FILED AS OF DATE: 20210318 DATE AS OF CHANGE: 20210318 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ROOT JONATHAN D CENTRAL INDEX KEY: 0001225480 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39293 FILM NUMBER: 21755865 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 2021-03-16 0001531048 Inari Medical, Inc. NARI 0001225480 ROOT JONATHAN D 1460 EL CAMINO REAL, SUITE 100 MENLO PARK CA 94025 1 0 1 0 Common Stock 2021-03-16 4 J 0 2619872 D 2619872 I Directly owned by USVP X Common Stock 2021-03-16 4 J 0 83814 D 83813 I Directly owned by AFF X Common Stock 2021-03-16 4 J 0 685827 A 685827 I Directly owned by PMG X Common Stock 2021-03-16 4 J 0 685827 D 0 I Directly owned by PMG X Common Stock 2021-03-16 4 J 0 94101 A 427892 D Represents a pro-rata in-kind distribution of the Issuer's common stock, and not a purchase or sale, without additional consideration to their respective partners, members and assignees, as applicable. Represents a pro-rata in-kind distribution of the Issuer's common stock held directly by each of U.S. Venture Partners X, L.P. ("USVP X") and USVP X Affiliates Fund L.P. ("AFF X" and, together with USVP X, the "USVP X Funds"), without additional consideration, to its partners. 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 securities held by the USVP X Funds. The Reporting Person, a director of the Issuer, is a managing member of PMG X with additional rights with respect to such shares, and deemed to have sole voting and dispositive power over the reported securities held by the USVP X Funds, and disclaims beneficial ownership of such securities, except to the extent of any pecuniary interest therein. Represents a pro-rata in-kind distribution of the Issuer's common stock to PMG X from each of the USVP X Funds, without additional consideration. The Reporting Person, a director of the Issuer, is a managing member of PMG X with additional rights with respect to the shares, and deemed to have sole voting and dispositive power over the reported securities held by PMG X, and disclaims beneficial ownership of such securities, except to the extent of any pecuniary interest therein. Represents a pro-rata in-kind distribution of the Issuer's common stock held directly by PMG X, without additional consideration to its members (the "PMG Distribution"). The Reporting Person, a director of the Issuer, is a managing member of PMG X with additional rights with respect to the shares, and may be deemed to have sole voting and dispositive power over the reported securities held by PMG X, and disclaims beneficial ownership of such securities held by PMG X, except to the extent of any pecuniary interest therein. Represents a change in the form of ownership from indirect to direct by virtue of the receipt of shares in the PMG X Distribution. Shares are held directly by the Reporting Person. Dale Holladay 2021-03-18