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