SEC Form 4 · accession 0001140361-17-038666

Restoration Robotics, Inc. · HAIR

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

Reporting owner

Director

Period of report

Oct 11, 2017

Accepted (ET)

Oct 13, 2017 · 6:44 pm EDT

Rule 10b5-1 plan

unknown — predates the checkbox

Issuer CIK

0001409269

Table I — non-derivative securities

No Table I lines on this filing.

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
Convertible Promissory Note^F2,F4,F3	$7.00	Oct 11, 2017	J	—	A	—	—	Common Stock	—	—	I

F1The securities were originally acquired from the Issuer on September 6, 2017; however, the conversion price was set upon the pricing of the Issuer's Initial Public Offering (the "IPO").
F2The amount reported represents the principal amount of the Reporting Person's Convertible Promissory Note (the "Note") only. Accrued interest of 5% per year based on the actual number of days outstanding through the conversion date will also convert.
F3The outstanding principal and accrued interest of the Note automatically converts into shares of the Issuer's Common Stock at the price per share available to the public as set forth in the final prospectus related to the IPO upon the closing of the IPO; if not so converted, the Note has a maturity date of September 6, 2018, at which time it will automatically convert into shares of the Issuer's capital stock.
F4The convertible promissory note is directly held by InterWest Partners IX, LP ("IWP IX"). InterWest Management Partners IX, LLC ("IWM LLC"), as the general partner of IWP IX, may be deemed to beneficially own the shares held by IWP IX. The Reporting Person is a managing director of IWM LLC, and as such may be deemed to beneficially own the shares held by IWP IX. The Reporting Person disclaims beneficial ownership of such shares except to the extent of any pecuniary interest therein.