0000899243-21-011699.txt : 20210315
0000899243-21-011699.hdr.sgml : 20210315
20210315190626
ACCESSION NUMBER: 0000899243-21-011699
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210311
FILED AS OF DATE: 20210315
DATE AS OF CHANGE: 20210315
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Nielsen Kirk G.
CENTRAL INDEX KEY: 0001523522
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39293
FILM NUMBER: 21743042
BUSINESS ADDRESS:
BUSINESS PHONE: 650-233-7877
MAIL ADDRESS:
STREET 1: ONE SANSOME STREET
STREET 2: SUITE 3630
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94104
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Inari Medical, Inc.
CENTRAL INDEX KEY: 0001531048
STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841]
IRS NUMBER: 452902923
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 9 PARKER, SUITE 100
CITY: IRVINE
STATE: CA
ZIP: 92618
BUSINESS PHONE: 949-923-4747
MAIL ADDRESS:
STREET 1: 9 PARKER, SUITE 100
CITY: IRVINE
STATE: CA
ZIP: 92618
FORMER COMPANY:
FORMER CONFORMED NAME: Inceptus Newco1 Inc.
DATE OF NAME CHANGE: 20110923
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2021-03-11
0
0001531048
Inari Medical, Inc.
NARI
0001523522
Nielsen Kirk G.
C/O INARI MEDICAL, INC.
9 PARKER, SUITE 100
IRVINE
CA
92618
1
0
0
0
Common Stock
2021-03-11
4
J
0
570957
0.00
D
0
I
See footnote
Common Stock
2021-03-11
4
J
0
147021
0.00
A
147021
I
See footnote
Common Stock
2021-03-11
4
J
0
147021
0.00
D
0
I
See footnote
Common Stock
2021-03-11
4
J
0
7955
0.00
A
46526
D
Common Stock
2021-03-11
4
J
0
3596
0.00
D
0
I
See footnote
Common Stock
2021-03-12
4
S
0
206
120.00
D
46320
D
Represents a pro-rata distribution, and not a purchase or sale, without additional consideration by Versant Venture Capital IV, L.P. ("Versant IV") to its partners.
Shares held by Versant IV. Versant Ventures IV, LLC ("Versant Ventures IV GP") is the general partner of Versant IV. The Reporting Person is a managing member of Versant Ventures IV GP and may be deemed to share voting and dispositive power over the shares held by Versant IV; however, he disclaims beneficial ownership of such securities, except to the extent of his pecuniary interests therein.
Represents a change in the form of ownership of Versant Ventures IV GP by virtue of the receipt of shares as a result of the pro-rata in-kind distribution of common stock of the Issuer for no consideration by Versant IV.
Shares held by Versant Ventures IV GP. The Reporting Person is a managing member of Versant Ventures IV GP and may be deemed to share voting and dispositive power over the shares held by Versant Ventures IV GP; however, he disclaims beneficial ownership of such securities, except to the extent of his pecuniary interests therein.
Represents a pro-rata distribution, and not a purchase or sale, without additional consideration by Versant Ventures IV GP to its members.
Represents a change in the form of ownership of the Reporting Person by virtue of the receipt of shares as a result of the pro-rata in-kind distribution of common stock of the Issuer for no consideration by Versant Ventures IV GP.
Represents a pro-rata distribution, and not a purchase or sale, without additional consideration by Versant Side Fund IV, L.P. ("Versant Side Fund") to its partners.
Shares held by Versant Side Fund. Versant Ventures IV GP is the general partner of Versant Side Fund. The Reporting Person is a managing member of Versant Ventures IV GP and may be deemed to share voting and dispositive power over the shares held by Versant Side Fund; however, he disclaims beneficial ownership of such securities, except to the extent of his pecuniary interests therein.
/s/ Robin L. Praeger, Attorney-in-Fact for Kirk Nielsen
2021-03-15