SEC Form 4 · accession 0000899243-18-029479

VAPOTHERM INC · VAPO

Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗

Reporting owner

10% Owner

Period of report

Nov 16, 2018

Accepted (ET)

Nov 20, 2018 · 5:10 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 Stock^F1	Nov 16, 2018	C	2,042,595	—	A	2,042,595	D
Common Stock^F2	Nov 16, 2018	C	208,752	—	A	2,251,347	D

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	D/I
Series A Convertible Preferred Stock^F1	—	Nov 16, 2018	C	227,600	D	—	—	Common Stock	227,600	D
Series B Convertible Preferred Stock^F1	—	Nov 16, 2018	C	75,700	D	—	—	Common Stock	75,700	D
Series C Convertible Preferred Stock^F1	—	Nov 16, 2018	C	849,239	D	—	—	Common Stock	849,239	D
Series D Convertible Preferred Stock^F1	—	Nov 16, 2018	C	890,056	D	—	—	Common Stock	890,056	D
Series D-1 Convertible Preferred Stock^F2	—	Nov 16, 2018	C	208,752	D	—	—	Common Stock	208,752	D

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.
F2Upon 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.