0001127602-23-004871.txt : 20230213 0001127602-23-004871.hdr.sgml : 20230213 20230213163128 ACCESSION NUMBER: 0001127602-23-004871 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20221231 FILED AS OF DATE: 20230213 DATE AS OF CHANGE: 20230213 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MILDER DONALD B CENTRAL INDEX KEY: 0001279660 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39293 FILM NUMBER: 23619015 MAIL ADDRESS: STREET 1: ONE SANSOME STREET STREET 2: SUITE 3630 CITY: SAN FRANCISCO STATE: CA ZIP: 94104 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: 6001 OAK CANYON, SUITE 100 CITY: IRVINE STATE: CA ZIP: 92618 BUSINESS PHONE: 949-923-4747 MAIL ADDRESS: STREET 1: 6001 OAK CANYON, SUITE 100 CITY: IRVINE STATE: CA ZIP: 92618 FORMER COMPANY: FORMER CONFORMED NAME: Inceptus Newco1 Inc. DATE OF NAME CHANGE: 20110923 5 1 form5.xml PRIMARY DOCUMENT X0306 5 2022-12-31 0 0 0001531048 Inari Medical, Inc. NARI 0001279660 MILDER DONALD B C/O INARI MEDICAL, INC. 6001 OAK CANYON IRVINE CA 92618 1 Common Stock 2022-11-17 5 G 0 210000 0 D 2975614 I Milder Community Property Trust Common Stock 249606 D The reporting person is a trustee of the Milder Community Property Trust DTD 11/7/91, as amended. /s/ Angela Ahmad, attorney-in-fact for Donald Milder 2023-02-13