0000899243-20-022449.txt : 20200814 0000899243-20-022449.hdr.sgml : 20200814 20200814182756 ACCESSION NUMBER: 0000899243-20-022449 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20200812 FILED AS OF DATE: 20200814 DATE AS OF CHANGE: 20200814 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Walrod Nicholas T. CENTRAL INDEX KEY: 0001752890 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38740 FILM NUMBER: 201107157 MAIL ADDRESS: STREET 1: 2540 NE MARTIN LUTHER KING, JR BOULEVARD CITY: PORTLAND STATE: OR ZIP: 97212 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 1 doc4.xml FORM 4 SUBMISSION X0306 4 2020-08-12 0 0001253176 VAPOTHERM INC VAPO 0001752890 Walrod Nicholas T. C/O VAPOTHERM INVESTORS, LLC 2540 NE MARTIN LUTHER KING JR. BLVD. PORTLAND OR 97212 0 0 1 0 Common Stock 2020-08-12 4 J 0 209992 0.00 D 3083997 I By 3x5 Partners, LLC Common Stock 2020-08-12 4 J 0 442806 0.00 D 2641191 I By 3x5 Partners, LLC Common Stock 2020-08-12 4 J 0 2625 0.00 A 2643816 I By 3x5 Partners, LLC Common Stock 2020-08-12 4 J 0 503 0.00 A 503 I By Nicholas T. Walrod Trust Distribution of shares by 3x5 Special Opportunity Fund, L.P. pro rata without consideration to its general partners and limited partners. A portion of this distribution was made pursuant to a sales plan adopted by 3x5 Special Opportunity Fund, L.P. and intended to comply with Rule 10b5-1 under the Securities Exchange Act of 1934. Distribution of shares by Vapotherm Investors, LLC pro rata without consideration to its members. A portion of this distribution was made pursuant to a sales plan adopted by Vapotherm Investors, LLC and intended to comply with Rule 10b5-1 under the Securities Exchange Act of 1934. The Reporting Person is a managing member of 3x5 Partners, LLC. 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. As a managing member of 3x5 Partners, LLC the Reporting Person 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. Consists of (i) 30,000 shares directly held by 3x5 Partners, LLC, (ii) 2,625 shares held by Arnerich 3x5 Special Opportunity Managers, L.P., of which 3x5 Partners, LLC is the general manager, (iii) 1,771,225 shares directly held by Vapotherm Investors, LLC and (iv) 839,966 shares directly held by 3x5 Special Opportunity Partners, L.P. /s/ Anthony Ten Haagen, as Attorney-In-Fact 2020-08-14