0000899243-20-028434.txt : 20201015 0000899243-20-028434.hdr.sgml : 20201015 20201015203151 ACCESSION NUMBER: 0000899243-20-028434 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: Bisgaard Peter CENTRAL INDEX KEY: 0001606387 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39616 FILM NUMBER: 201242566 MAIL ADDRESS: STREET 1: 11804 NORTH CREEK PARKWAY SOUTH CITY: BOTHELL STATE: WA ZIP: 98011 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 0001606387 Bisgaard Peter C/O EARGO, INC. 1600 TECHNOLOGY DRIVE, 6TH FLOOR SAN JOSE CA 95110 1 0 0 0 Series C Preferred Stock Common Stock 11086 D Series C Preferred Stock Common Stock 1330361 I See Footnote Series D Preferred Stock Common Stock 3738 D Series D Preferred Stock Common Stock 261701 I See Footnote Series E Preferred Stock Common Stock 24907 D Series E Preferred Stock Common Stock 849858 I See Footnote The shares of the Issuer's Series C Preferred Stock automatically convert into shares of the Issuer's Common Stock, for no additional consideration, on a 1:1.118772093 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 Pivotal Alpha Limited ("Pivotal"). Investment and voting decisions by Pivotal are made jointly by the executive committee of Nan Fung Group Holdings Limited (the "NFGHL Executive Committee"), which indirectly owns Pivotal. Kam Chung Leung, Frank Kai Shui Seto, Vincent Sai Sing Cheung, Pui Kuen Cheung, Kin Ho Kwok, Vanessa Tih Lin Cheung, Meng Gao and Chun Wai Nelson Tang are each on the NFGHL Executive Committee. Mr. Bisgaard is a Managing Partner of Pivotal Bioventure Partners LLC, which is affiliated with Pivotal, and disclaims beneficial ownership of all applicable shares except to the extent of his actual pecuniary interest in such shares. The shares of the Issuer's Series D Preferred Stock automatically convert into shares of the Issuer's Common Stock, for no additional consideration, on a 1:1.246748888 basis immediately prior to the consummation of the Issuer's initial public offering. 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. /s/ Christy La Pierre, Attorney-in-Fact for Peter Bisgaard 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.

                                           /s/ Peter Bisgaard
                                           -----------------------
                                           By:  Peter Bisgaard