0001790300-21-000004.txt : 20210910 0001790300-21-000004.hdr.sgml : 20210910 20210910162326 ACCESSION NUMBER: 0001790300-21-000004 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210908 FILED AS OF DATE: 20210910 DATE AS OF CHANGE: 20210910 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Army Joseph CENTRAL INDEX KEY: 0001435005 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38740 FILM NUMBER: 211247314 MAIL ADDRESS: STREET 1: ONE WASHINGTON CENTER, SUITE 400 CITY: DOVER STATE: NH ZIP: 03820 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 primary_doc.xml PRIMARY DOCUMENT X0306 4 2021-09-08 0 0001253176 VAPOTHERM INC VAPO 0001435005 Army Joseph 100 DOMAIN DRIVE EXETER NH 03833 1 1 0 0 President and CEO Common Stock 2021-09-08 4 J 0 9871 0 A 719792 D Common Stock 2021-09-08 4 J 0 787 0 A 720579 D Common Stock 500 I By spouse Distribution of shares by Vapotherm Investors, LLC pro rata without consideration to its members. Distribution of shares by 3x5 Special Opportunity Fund, L.P. pro rata without consideration to its general partners and limited partners. Includes 27,700 shares that will be issued over time upon vesting pursuant to restricted stock units granted under the Vapotherm, Inc. 2018 Equity Incentive Plan. These shares will be issued over time upon vesting pursuant to a restricted stock unit granted to the Reporting Person's spouse under the Vapotherm, Inc. 2018 Equity Incentive Plan. /s/Adrain Bryant, as Attorney In Fact 2021-09-10