0001493152-19-019411.txt : 20191218
0001493152-19-019411.hdr.sgml : 20191218
20191218165820
ACCESSION NUMBER: 0001493152-19-019411
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20191216
FILED AS OF DATE: 20191218
DATE AS OF CHANGE: 20191218
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Burstein Martin
CENTRAL INDEX KEY: 0001748671
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38677
FILM NUMBER: 191293064
MAIL ADDRESS:
STREET 1: C/O RA MEDICAL SYSTEMS, INC.
STREET 2: 2070 LAS PALMAS DRIVE
CITY: CARLSBAD
STATE: CA
ZIP: 92011
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Martin Burstein Living Trust Dated January 28, 2002
CENTRAL INDEX KEY: 0001748362
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38677
FILM NUMBER: 191293065
BUSINESS ADDRESS:
STREET 1: C/O RA MEDICAL SYSTEMS, INC.
STREET 2: 2070 LAS PALMAS DRIVE
CITY: CARLSBAD
STATE: CA
ZIP: 92011
BUSINESS PHONE: 760-804-1648
MAIL ADDRESS:
STREET 1: C/O RA MEDICAL SYSTEMS, INC.
STREET 2: 2070 LAS PALMAS DRIVE
CITY: CARLSBAD
STATE: CA
ZIP: 92011
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
ownership.xml
X0306
4
2019-12-16
0
0001716621
Ra Medical Systems, Inc.
RMED
0001748671
Burstein Martin
7393 MELODIA TER.
CARLSBAD
CA
92011
0
0
1
0
0001748362
Martin Burstein Living Trust Dated January 28, 2002
7393 MELODIA TER.
CARLSBAD
CA
92011
0
0
1
0
Common Stock
2019-12-16
4
S
0
22436
0.75
D
1610651
I
See Footnote
Common Stock
2019-12-17
4
S
0
4448
0.75
D
1606203
I
See Footnote
Common Stock
350000
I
See Footnote
The price reported is a weighted average. These shares were sold in multiple transactions at prices ranging from not less than $0.75 to not more than $0.80. The reporting person undertakes to the issuer, any security holder of the issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the shares sold at each separate price within the ranges set forth in the footnotes to this Form 4 that report a range of prices.
Shares held of record by a family trust of which Martin Burstein is the sole trustee.
The price reported is a weighted average. These shares were sold in multiple transactions at prices ranging from not less than $0.75 to not more than $0.76.
Shares held of record by a family trust of which Mr. Burstein's spouse is the sole trustee.
/s/ Martin Burstein
2019-12-18
/s/ Martin Burstein for Martin Burstein Living Trust dated January 28, 2002
2019-12-18