SEC Form 4 · accession 0000899243-18-029473
VAPOTHERM INC · VAPO
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Period of report
Nov 16, 2018
Accepted (ET)
Nov 20, 2018 · 5:08 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 | 1,262,504 | — | A | 1,262,504 | D | |
| Common StockF6 | Nov 16, 2018 | C | 35,713 | — | A | 1,298,217 | 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,F2 | — | Nov 16, 2018 | C | 372,206 | D | — | — | Common Stock | 372,206 | 0 | D |
| Series B Convertible Preferred StockF1,F3 | — | Nov 16, 2018 | C | 145,252 | D | — | — | Common Stock | 145,252 | 0 | D |
| Series C Convertible Preferred StockF1,F4 | — | Nov 16, 2018 | C | 430,937 | D | — | — | Common Stock | 430,937 | 0 | D |
| Series D Convertible Preferred StockF1,F5 | — | Nov 16, 2018 | C | 314,109 | D | — | — | Common Stock | 314,109 | 0 | D |
| Series D-1 Convertible Preferred StockF6,F2,F7 | — | Nov 16, 2018 | C | 35,713 | D | — | — | Common Stock | 35,713 | 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, Series C Convertible Preferred Stock and Series D 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, the Series C Convertible Preferred Stock or the Series D Convertible Preferred Stock.
- F2Consists of (i) 163,365 shares held by SightLine Healthcare Opportunity Fund II, (ii) 56,994 shares held by SightLine Healthcare Opportunity Fund II-A and (iii) 151,847 shares held by SightLine Healthcare Opportunity Fund II-B.
- F3Consists of (i) 63,753 shares held by SightLine Healthcare Opportunity Fund II, (ii) 22,241 shares held by SightLine Healthcare Opportunity Fund II-A and (iii) 59,258 shares held by SightLine Healthcare Opportunity Fund II-B.
- F4Consists of (i) 189,144 shares held by SightLine Healthcare Opportunity Fund II, (ii) 65,986 shares held by SightLine Healthcare Opportunity Fund II-A and (iii) 175,807 shares held by SightLine Healthcare Opportunity Fund II-B.
- F5Consists of (i) 137,866 shares held by SightLine Healthcare Opportunity Fund II, (ii) 48,098 shares held by SightLine Healthcare Opportunity Fund II-A and (iii) 128,145 shares held by SightLine Healthcare Opportunity Fund II-B.
- F6Upon closing of the Issuer's initial public offering, each share of Series D-1 Convertible Preferred Stock automatically converted into 1.137 shares of Common Stock without payment or further consideration. There was no expiration date for the Series D-1 Convertible Preferred Stock.
- F7Consists of 35,713 shares held by SightLine Investors, LLC.