0001209191-20-059388.txt : 20201119 0001209191-20-059388.hdr.sgml : 20201119 20201119162903 ACCESSION NUMBER: 0001209191-20-059388 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20201117 FILED AS OF DATE: 20201119 DATE AS OF CHANGE: 20201119 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Jackson Andrew C. CENTRAL INDEX KEY: 0001636738 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38677 FILM NUMBER: 201329106 MAIL ADDRESS: STREET 1: 11988 EL CAMINO REAL STE. 650 CITY: SAN DIEGO STATE: CA ZIP: 92130 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 2020-11-17 0 0001716621 Ra Medical Systems, Inc. RMED 0001636738 Jackson Andrew C. C/O RA MEDICAL SYSTEMS, INC. 2070 LAS PALMAS DRIVE CARLSBAD CA 92011 0 1 0 0 CFO Common Stock 2020-11-17 4 A 0 35276 0.00 A 37284 D The reported shares were issued as a restricted stock award ("RSA"). 50% of the shares underlying the RSA shall vest and become non-forfeitable as follows: 1/3 of the number of shares will vest on November 20, 2021, and 1/6th of the number of shares will vest on each May 20 and November 20 thereafter, such that 50% of the RSA will be fully vested on November 20, 2023; provided, however, that if a vesting date would otherwise fall on a day when the national stock exchange upon which the shares are listed is not open for trading, vesting will occur on the first trading day thereafter. The remaining 50% of the shares underlying the RSA shall vest and become non-forfeitable upon certain performance milestones being met by November 20, 2021. Vesting in all instances is subject to the reporting person's continuous status as a Service Provider (as defined in the 2018 Equity Incentive Plan) through each vesting date. On November 16, 2020, the common stock of the company reverse-split 25-for-1, resulting in the reporting persons ownership being reduced by 48,194. /s/ Daniel Horwood, as Attorney-in-Fact 2020-11-19