0000899243-20-001948.txt : 20200124 0000899243-20-001948.hdr.sgml : 20200124 20200124160313 ACCESSION NUMBER: 0000899243-20-001948 CONFORMED SUBMISSION TYPE: 4/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20200102 FILED AS OF DATE: 20200124 DATE AS OF CHANGE: 20200124 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Arnerich Anthony L. CENTRAL INDEX KEY: 0001752635 FILING VALUES: FORM TYPE: 4/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-38740 FILM NUMBER: 20545452 MAIL ADDRESS: STREET 1: 100 DOMAIN DRIVE CITY: EXETER STATE: NH ZIP: 03833 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: VAPOTHERM INC CENTRAL INDEX KEY: 0001253176 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 100 DOMAIN DRIVE CITY: EXETER STATE: NH ZIP: 03833 BUSINESS PHONE: 603-658-0411 MAIL ADDRESS: STREET 1: 100 DOMAIN DRIVE CITY: EXETER STATE: NH ZIP: 03833 4/A 1 doc4a.xml FORM 4/A SUBMISSION X0306 4/A 2020-01-02 2020-01-03 0 0001253176 VAPOTHERM INC VAPO 0001752635 Arnerich Anthony L. C/O VAPOTHERM INVESTORS, LLC 2540 NE MARTIN LUTHER KING JR. BLVD. PORTLAND OR 97212 1 0 1 0 Common Stock 2020-01-02 4 A 0 1021 0.00 A 3799 D Common Stock 3374162 I By 3x5 Partners, LLC Compensation for services rendered during the fourth quarter of 2019, in accordance with the Issuer's non-employee director compensation and equity plans. Consists of (i) 30,000 shares directly held by 3x5 Partners, LLC, (ii) 2,294,204 shares directly held by Vapotherm Investors, LLC and (iii) 1,049,958 shares directly held by 3x5 Special Opportunity Partners, L.P. 3x5 Partners, LLC is the managing member of Vapotherm Investors, LLC and a member of 3x5 Special Opportunity Partners, LLC, which is the general partner of 3x5 Special Opportunity Fund, L.P., and by virtue of these relationships 3x5 Partners, LLC may be deemed to indirectly beneficially own the shares directly held by Vapotherm Investors, LLC and 3x5 Special Opportunity Partners, L.P. The Reporting Person is a managing member of 3x5 Partners, LLC and shares voting and dispositive power over such securities. The Reporting Person disclaims beneficial ownership, within the meaning of Section 16 of the Securities Exchange Act of 1934, as amended, or otherwise, of such securities except to the extent of his pecuniary interest therein. /s/Anthony Ten Haagen, as Attorney In Fact 2020-01-24