0001209191-21-069776.txt : 20211215 0001209191-21-069776.hdr.sgml : 20211215 20211215170126 ACCESSION NUMBER: 0001209191-21-069776 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211213 FILED AS OF DATE: 20211215 DATE AS OF CHANGE: 20211215 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Clapper David M CENTRAL INDEX KEY: 0001306990 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40919 FILM NUMBER: 211494866 MAIL ADDRESS: STREET 1: 3003 TASMAN DRIVE CITY: SANTA CLARA STATE: CA ZIP: 95054 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: MINERVA SURGICAL INC CENTRAL INDEX KEY: 0001452965 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 263422906 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 4255 BURTON DRIVE CITY: SANTA CLARA STATE: CA ZIP: 95054 BUSINESS PHONE: (855) 646-7874 MAIL ADDRESS: STREET 1: 4255 BURTON DRIVE CITY: SANTA CLARA STATE: CA ZIP: 95054 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2021-12-13 0 0001452965 MINERVA SURGICAL INC UTRS 0001306990 Clapper David M C/O MINERVA SURGICAL, INC. 4255 BURTON DRIVE SANTA CLARA CA 95054 1 1 0 0 President and CEO Common Stock 2021-12-13 4 P 0 25000 4.9374 A 642660 I See Footnote These shares are held by David M. Clapper & Toni C. Clapper, Trustees of the Clapper Family Trust dated December 16, 2004. Lenka Schvaigerova, Attorney-in-fact for David M Clapper 2021-12-15