SEC Form 4 · accession 0000899243-18-029470
VAPOTHERM INC · VAPO
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
3x5 Special Opportunity Fund, L.P.
10% Owner
Period of report
Nov 16, 2018
Accepted (ET)
Nov 20, 2018 · 5:05 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001253176
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Nov 16, 2018 | C | 1,049,958 | — | A | 1,049,958 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Series A Convertible Preferred StockF1 | — | Nov 16, 2018 | C | 500,000 | D | — | — | Common Stock | 500,000 | 0 | D |
| Series B Convertible Preferred StockF1 | — | Nov 16, 2018 | C | 285,714 | D | — | — | Common Stock | 285,714 | 0 | D |
| Series C Convertible Preferred StockF1 | — | Nov 16, 2018 | C | 264,244 | D | — | — | Common Stock | 264,244 | 0 | D |
Explanation of responses
- F1Upon closing of the Issuer's initial public offering, each share of Series A Convertible Preferred Stock, Series B Convertible Preferred Stock and Series C Convertible Preferred Stock automatically converted into one share of Common Stock without payment or further consideration. There was no expiration date for the Series A Convertible Preferred Stock, the Series B Convertible Preferred Stock or the Series C Convertible Preferred Stock.