0001209191-20-032403.txt : 20200527 0001209191-20-032403.hdr.sgml : 20200527 20200527182723 ACCESSION NUMBER: 0001209191-20-032403 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: Hoffman William CENTRAL INDEX KEY: 0001304099 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39293 FILM NUMBER: 20916526 MAIL ADDRESS: STREET 1: C/O FOXHOLLOW TECHNOLOGIES, INC. STREET 2: 740 BAY ROAD CITY: REDWOOD CITY STATE: CA ZIP: 94063 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 0001304099 Hoffman William C/O INARI MEDICAL, INC. 9 PARKER, SUITE 100 IRVINE CA 92618 1 1 0 0 President and CEO Common Stock 2020-05-27 4 P 0 13095 19.00 A 1232283 D Common Stock 2020-05-27 4 C 0 89633 A 1321916 D Series B Preferred Stock 2020-05-27 4 C 0 29925 D Common Stock 29925 0 D Series C Preferred Stock 2020-05-27 4 C 0 59708 D Common Stock 59708 0 D 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. /s/ Mitchell Hill, Attorney-in-Fact for William Hoffman 2020-05-27