0000950103-21-009179.txt : 20210622 0000950103-21-009179.hdr.sgml : 20210622 20210622171155 ACCESSION NUMBER: 0000950103-21-009179 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210617 FILED AS OF DATE: 20210622 DATE AS OF CHANGE: 20210622 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Malik Shahzad CENTRAL INDEX KEY: 0001380178 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39430 FILM NUMBER: 211036185 MAIL ADDRESS: STREET 1: 2273 RESEARCH BLVD, SUITE 400 CITY: ROCKVILLE STATE: MD ZIP: 20850 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Acutus Medical, Inc. CENTRAL INDEX KEY: 0001522860 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 451306615 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 2210 FARADAY AVE STREET 2: SUITE 100 CITY: CARLSBAD STATE: CA ZIP: 92008 BUSINESS PHONE: 442-232-6080 MAIL ADDRESS: STREET 1: 2210 FARADAY AVE STREET 2: SUITE 100 CITY: CARLSBAD STATE: CA ZIP: 92008 4 1 dp152982_4-malik.xml FORM 4 X0306 4 2021-06-17 0 0001522860 Acutus Medical, Inc. AFIB 0001380178 Malik Shahzad C/O ACUTUS MEDICAL, INC. 2210 FARADAY AVE., SUITE 100 CARLSBAD CA 92008 1 0 0 0 Common Stock 2021-06-17 4 A 0 1800 0 A 4022 D Common Stock 65436 I See footnote Common Stock 1551713 I See footnote Stock Options (Right to Buy) 16.66 2021-06-17 4 A 0 7022 0 A 2031-06-17 Common Stock 7022 7022 D Each annual restricted stock unit ("Annual RSU") will be scheduled to vest as to all of the shares of Common Stock ("Shares") subject to such Annual RSU on the first anniversary of the date of grant of such Annual RSU, if on such date the Reporting person has remained in continuous service as a director These shares are held by Advent Life Sciences LLP ("Advent"). The Reporting Person is a general partner of Advent, and disclaims beneficial ownership of the securities held by Advent except to the extent of his indirect pecuniary interest therein. These shares are held by Advent Life Sciences Fund I LP. Advent is the general partner of Advent Life Sciences Fund II LP and the Reporting Person is a general partner of Advent. The Reporting Person disclaims beneficial ownership of the securities held by Advent Life Sciences Fund II LP except to the extent of his indirect pecuniary interest therein. Each annual stock option (the "Annual Option") will be scheduled to vest and become exercisable as to all of the Shares subject to such Annual Option on the first anniversary of the date of grant of such Annual Option, if on such date the Reporting Person has remained in continuous service as a director. /s/ Tom Sohn as attorney-in-fact for Shahzad Malik 2021-06-21