SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
Presidio Management Group X LLC

(Last) (First) (Middle)
1460 EL CAMINO REAL, SUITE 100

(Street)
MENLO PARK CA 94025

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
Inari Medical, Inc. [ NARI ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
05/27/2020
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
Form filed by One Reporting Person
X Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 05/27/2020 C 2,307,142 A (1) 2,307,142 I Directly owned by USVP X(2)
Common Stock 05/27/2020 C 2,899,876 A (1) 5,207,018 I Directly owned by USVP X(2)
Common Stock 05/27/2020 C 2,278,331 A (1) 7,485,349 I Directly owned by USVP X(2)
Common Stock 05/27/2020 C 73,809 A (1) 73,809 I Directly owned by AFF X(2)
Common Stock 05/27/2020 C 92,771 A (1) 166,580 I Directly owned by AFF X(2)
Common Stock 05/27/2020 C 72,887 A (1) 239,467 I Directly owned by AFF X(2)
Common Stock 05/27/2020 P 97,962 A $19 97,962 I Directly owned by Casey Tansey
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Series A Preferred Stock (1) 05/27/2020 C 2,307,142 (1) (1) Common Stock 2,307,142 $0 0 I Directly owned by USVP X(2)
Series A Preferred Stock (1) 05/27/2020 C 73,809 (1) (1) Common Stock 73,809 $0 0 I Directly owned by AFF X(2)
Series B Preferred Stock (1) 05/27/2020 C 2,899,876 (1) (1) Common Stock 2,899,876 $0 0 I Directly owned by USVP X(2)
Series B Preferred Stock (1) 05/27/2020 C 92,771 (1) (1) Common Stock 92,771 $0 0 I Directly owned by AFF X(2)
Series C Preferred Stock (1) 05/27/2020 C 2,278,331 (1) (1) Common Stock 2,278,331 $0 0 I Directly owned by USVP X(2)
Series C Preferred Stock (1) 05/27/2020 C 72,887 (1) (1) Common Stock 72,887 $0 0 I Directly owned by AFF X(2)
1. Name and Address of Reporting Person*
Presidio Management Group X LLC

(Last) (First) (Middle)
1460 EL CAMINO REAL, SUITE 100

(Street)
MENLO PARK CA 94025

(City) (State) (Zip)
1. Name and Address of Reporting Person*
US VENTURE PARTNERS X LP

(Last) (First) (Middle)
1460 EL CAMINO REAL, SUITE 100

(Street)
MENLO PARK CA 94025

(City) (State) (Zip)
1. Name and Address of Reporting Person*
USVP X AFFILIATES LP

(Last) (First) (Middle)
1460 EL CAMINO REAL, SUITE 100

(Street)
MENLO PARK CA 94025

(City) (State) (Zip)
1. Name and Address of Reporting Person*
FEDERMAN IRWIN

(Last) (First) (Middle)
1460 EL CAMINO REAL, SUITE 100

(Street)
MENLO PARK CA 94025

(City) (State) (Zip)
1. Name and Address of Reporting Person*
KRAUSZ STEVEN M

(Last) (First) (Middle)
1460 EL CAMINO REAL, SUITE 100

(Street)
MENLO PARK CA 94025

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Lewis Richard W.

(Last) (First) (Middle)
1460 EL CAMINO REAL, SUITE 100

(Street)
MENLO PARK CA 94025

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Matteucci Paul A

(Last) (First) (Middle)
1460 EL CAMINO REAL, SUITE 100

(Street)
MENLO PARK CA 94025

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Tansey Casey M

(Last) (First) (Middle)
1460 EL CAMINO REAL, SUITE 100

(Street)
MENLO PARK CA 94025

(City) (State) (Zip)
Explanation of Responses:
1. Each share of the Issuer's preferred stock is convertible on a one-to-one basis into shares of the Issuer's common stock at the holder's election and has no expiration date. The preferred stock will automatically convert into common stock upon the closing of the Issuer's initial public offering.
2. The reported securities are owned directly by each of U.S. Venture Partners X, L.P. ("USVP X") and USVP X Affiliates Fund, L.P. ("AFF X") (together, the "USVP X Funds"). Presidio Management Group X, L.L.C. ("PMG X") is the general partner of each of the USVP X Funds and may be deemed to have sole voting and dispositive power over the reported securities held by the USVP X Funds. Jonathan D. Root, a director of the issuer, Irwin Federman, Steven Krausz, Richard Lewis, Paul Matteucci and Casey Tansey are the managing members of PMG X, who may be deemed to share voting and dispositive power over the reported securities held by the USVP X Funds. Such persons and entities disclaim beneficial ownership of the reported securities held by the USVP X Funds, except to the extent of any pecuniary interest therein
Remarks:
Presidio Management Group X, L.L.C., By: /s/ Dale Holladay - Attorney in Fact 05/27/2020
U.S. Venture Partners X, L.P, By: /s/ Dale Holladay - Attorney in Fact 05/27/2020
USVP X Affiliates, L.P, By: /s/ Dale Holladay - Attorney in Fact 05/27/2020
Irwin Federman, By: /s/ Dale Holladay - Attorney in Fact 05/27/2020
Steven M Krausz, By: /s/ Dale Holladay - Attorney in Fact 05/27/2020
Richard W. Lewis, By: /s/ Dale Holladay - Attorney in Fact 05/27/2020
Paul Matteucci, By: /s/ Dale Holladay - Attorney in Fact 05/27/2020
Casey M. Tansey, By: /s/ Dale Holladay - Attorney in Fact 05/27/2020
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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