0001209191-20-032409.txt : 20200527 0001209191-20-032409.hdr.sgml : 20200527 20200527183339 ACCESSION NUMBER: 0001209191-20-032409 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20200527 FILED AS OF DATE: 20200527 DATE AS OF CHANGE: 20200527 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MILDER DONALD B CENTRAL INDEX KEY: 0001279660 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39293 FILM NUMBER: 20916535 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: 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 doc4.xml FORM 4 SUBMISSION X0306 4 2020-05-27 0 0001531048 Inari Medical, Inc. NARI 0001279660 MILDER DONALD B C/O INARI MEDICAL, INC. 9 PARKER, SUITE 100 IRVINE CA 92618 1 0 1 0 Common Stock 2020-05-27 4 P 0 239841 19.00 A 239841 D Common Stock 2020-05-27 4 C 0 5033614 A 5033614 I Milder Community Property Trust Restricted Stock Unit 2020-05-27 4 A 0 8947 19.00 A Common Stock 8947 8947 D Series B Preferred Stock 2020-05-27 4 C 0 3591179 D Common Stock 3591179 0 I Milder Community Property Trust Series C Preferred Stock 2020-05-27 4 C 0 1442435 D Common Stock 1442435 0 I Milder Community Property Trust Upon the closing of the Issuer's initial public offering, each share of preferred stock automatically converted into shares of the Issuer's common stock on a one-for-one basis. The reporting person is a trustee of the Milder Community Property Trust DTD 11/7/91, as amended. The restricted stock unit vests in three equal annual installments beginning on May 27, 2020. /s/ Mitchell Hill, Attorney-in-Fact for Donald Milder 2020-05-27