0000899243-20-028469.txt : 20201015 0000899243-20-028469.hdr.sgml : 20201015 20201015212450 ACCESSION NUMBER: 0000899243-20-028469 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20201015 FILED AS OF DATE: 20201015 DATE AS OF CHANGE: 20201015 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Gilde Healthcare Holding B.V. CENTRAL INDEX KEY: 0001420106 STATE OF INCORPORATION: P7 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39616 FILM NUMBER: 201242658 BUSINESS ADDRESS: STREET 1: NEWTONLAAN 91 STREET 2: PO BOX 85067 CITY: 3508 UTRECHT STATE: P7 ZIP: AB BUSINESS PHONE: 31(0)30-2192549 MAIL ADDRESS: STREET 1: NEWTONLAAN 91 STREET 2: PO BOX 85067 CITY: 3508 UTRECHT STATE: P7 ZIP: AB ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Eargo, Inc. CENTRAL INDEX KEY: 0001719395 STANDARD INDUSTRIAL CLASSIFICATION: ORTHOPEDIC, PROSTHETIC & SURGICAL APPLIANCES & SUPPLIES [3842] IRS NUMBER: 273879804 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1600 TECHNOLOGY DRIVE STREET 2: 6TH FLOOR CITY: SAN JOSE STATE: CA ZIP: 95110 BUSINESS PHONE: 650-351-7700 MAIL ADDRESS: STREET 1: 1600 TECHNOLOGY DRIVE STREET 2: 6TH FLOOR CITY: SAN JOSE STATE: CA ZIP: 95110 3 1 doc3.xml FORM 3 SUBMISSION X0206 3 2020-10-15 0 0001719395 Eargo, Inc. EAR 0001420106 Gilde Healthcare Holding B.V. NEWTONLAAN 91 3584 BP UTRECHT P7 NETHERLANDS 0 0 1 0 Series E Preferred Stock Common Stock 3685358 I See Footnote The shares of the Issuer's Series E Preferred Stock automatically convert into shares of the Issuer's Common Stock, for no additional consideration, on a 1:1 basis immediately prior to the consummation of the Issuer's initial public offering. The expiration date is not relevant to the conversion of these securities. These shares are held directly by Cooperatieve Gilde Healthcare V U.A. ("Gilde"). Gilde is managed by Gilde Healthcare V Management B.V. ("Management"). Management. is owned by Gilde Healthcare Holding B.V. ("Holding"). Each of Management and Holding may be deemed to have voting, investment and dispositive power with respect to the securities held by Gilde. Each of Management and Holding disclaims beneficial ownership of these securities and this report shall not be deemed an admission that any of them is the beneficial owner of such securities, except to the extent of their respective pecuniary interests therein. Exhibit 24 - Power of Attorney. Cooperatieve Gilde Healthcare V U.A., By: /s/ Christy La Pierre, Attorney-in-Fact 2020-10-15 Gilde Healthcare IV Management B.V., By: /s/ Christy La Pierre, Attorney-in-Fact 2020-10-15 Gilde Healthcare Holding B.V., By: /s/ Christy La Pierre, Attorney-in-Fact 2020-10-15 EX-24 2 attachment1.htm EX-24 DOCUMENT

                                  Eargo, Inc.

                               Power of Attorney

        Know all by these presents, that the undersigned hereby constitutes and
appoints each of (i) the Chief Executive Officer of Eargo, Inc., a Delaware
corporation (the "Company"), who is currently Christian Gormsen, (ii) the
Company's Chief Financial Officer, who is currently Adam Laponis, and (iii) the
Company's Chief Legal Officer, who is currently Christy La Pierre, and their
respective successors (including anyone serving in such capacities on an interim
or acting basis), signing singly, with full powers of substitution, as the
undersigned's true and lawful attorney-in-fact to:

    1.  prepare, execute in the undersigned's name and on the undersigned's
        behalf, and submit to the U.S. Securities and Exchange Commission (the
        "SEC") a Form ID, including amendments thereto, and any other documents
        necessary or appropriate to obtain codes and passwords enabling the
        undersigned to make electronic filings with the SEC of reports required
        by Section 16(a) of the Securities Exchange Act of 1934 or any rule or
        regulation of the SEC;

    2.  execute for and on behalf of the undersigned, in the undersigned's
        capacity as a director of the Company, Forms 3, 4, and 5 and any
        amendments thereto in accordance with Section 16(a) of the Securities
        Exchange Act of 1934 and the rules thereunder;

    3.  do and perform any and all acts for and on behalf of the undersigned
        which may be necessary or desirable to complete and execute any such
        Form 3, 4, or 5, complete and execute any amendment or amendments
        thereto, and timely file such form with the SEC and any stock exchange
        or similar authority; and

    4.  take any other action of any type whatsoever in connection with the
        foregoing which, in the opinion of such attorney-in-fact, may be of
        benefit to, in the best interest of, or legally required by, the
        undersigned, it being understood that the documents executed by such
        attorney-in-fact on behalf of the undersigned pursuant to this Power of
        Attorney shall be in such form and shall contain such terms and
        conditions as such attorney-in-fact may approve in such attorney-in-
        fact's discretion.

        The undersigned hereby grants to each such attorney-in-fact full power
and authority to do and perform any and every act and thing whatsoever
requisite, necessary, or proper to be done in the exercise of any of the rights
and powers herein granted, as fully to all intents and purposes as the
undersigned might or could do if personally present, with full power of
substitution or revocation, hereby ratifying and confirming all that such
attorney-in-fact, or such attorney-in-fact's substitute or substitutes, shall
lawfully do or cause to be done by virtue of this power of attorney and the
rights and powers herein granted. The undersigned acknowledges that the
foregoing attorneys-in-fact, in serving in such capacity at the request of the
undersigned, are not assuming, nor is the Company assuming, any of the
undersigned's responsibilities to comply with Section 16 of the Securities
Exchange Act of 1934.

        This Power of Attorney shall remain in full force and effect until the
undersigned is no longer required to file Forms 3, 4, and 5 with respect to the
undersigned's holdings of and transactions in securities issued by the Company,
unless earlier revoked by the undersigned in a signed writing delivered to the
foregoing attorneys-in-fact.

                                  IN WITNESS WHEREOF, the undersigned has
                                  caused this Power of Attorney to be executed
                                  as of this 30th day of September, 2020.

                                  Cooperatieve Gilde Healthcare V U.A.

                                  By:    /s/ Marc Perret
                                         -----------------------------------
                                  Name:  Marc Perret
                                  Title: Managing Director


                                  Gilde Healthcare V Management B.V.

                                  By:    /s/ Marc Perret
                                         -----------------------------------
                                  Name:  Marc Perret
                                  Title: Managing Director


                                  Gilde Healthcare Holding B.V.

                                  By:    /s/ Marc Perret
                                         ------------------------------------
                                  Name:  Marc Perret
                                  Title: Managing Director