0001209191-21-002582.txt : 20210107
0001209191-21-002582.hdr.sgml : 20210107
20210107181029
ACCESSION NUMBER: 0001209191-21-002582
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210105
FILED AS OF DATE: 20210107
DATE AS OF CHANGE: 20210107
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Mejia Richard Jr
CENTRAL INDEX KEY: 0001445578
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38677
FILM NUMBER: 21515090
MAIL ADDRESS:
STREET 1: 2200 FARADAY AVENUE
STREET 2: SUITE 100
CITY: CARLSBAD
STATE: CA
ZIP: 92008
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Ra Medical Systems, Inc.
CENTRAL INDEX KEY: 0001716621
STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841]
IRS NUMBER: 383661826
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 2070 LAS PALMAS DRIVE
CITY: CARLSBAD
STATE: CA
ZIP: 92011
BUSINESS PHONE: (760) 804-1648
MAIL ADDRESS:
STREET 1: 2070 LAS PALMAS DRIVE
CITY: CARLSBAD
STATE: CA
ZIP: 92011
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2021-01-05
0
0001716621
Ra Medical Systems, Inc.
RMED
0001445578
Mejia Richard Jr
C/O RA MEDICAL SYSTEMS, INC.
2070 LAS PALMAS DRIVE
CARLSBAD
CA
92011
1
0
0
0
Common Stock
2021-01-05
4
A
0
9423
0.00
A
17946
D
The Reporting Person has elected to receive his 2021 retainer compensation in restricted stock, rather than cash. Subject to the Reporting Person continuing to be a "Service Provider" (as defined in the Company's 2018 Equity Incentive Plan) through each vesting date, the shares shall vest as follows: 25% of the shares subject to the restricted stock award shall vest quarterly on the fifth of the month immediately following the end of the quarter corresponding with the date of grant (i.e. April 5, 2021, July 5, 2021, October 5, 2021, and January 5, 2022), such that the shares shall be fully vested on January 5, 2022.
/s/ Daniel Horwood, as Attorney-in-Fact
2021-01-07