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