SEC Form 4 · accession 0001225208-17-016386

Restoration Robotics, Inc. · HAIR

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

Reporting owner

Jeffrey W Bird

Director · 10% Owner

Period of report

Oct 16, 2017

Accepted (ET)

Oct 18, 2017 · 2:59 pm EDT

Rule 10b5-1 plan

unknown — predates the checkbox

Issuer CIK

0001409269

Table I — non-derivative securities

Security	Date	Code	Shares	Price	A/D	Owned after	D/I	Nature of ownership
Common Stock^F1,F2	Oct 16, 2017	C	40,982	$0.00	A	40,982	I	By Irrevocable Trust (BICT)
Common Stock^F1,F3	Oct 16, 2017	C	31,747	$0.00	A	31,747	I	By Ltd Partnership (NEST)
Common Stock^F1,F4	Oct 16, 2017	C	888,690	$0.00	A	888,690	I	By Ltd Partnership (SHV)
Common Stock^F1,F4	Oct 16, 2017	C	606,386	$0.00	A	1,495,076	I	By Ltd Partnership (SHV)
Common Stock^F1,F4	Oct 16, 2017	C	479,145	$0.00	A	1,974,221	I	By Ltd Partnership (SHV)
Common Stock^F4	Oct 16, 2017	C	105,369	$7.00	A	2,079,590	I	By Ltd Partnership (SHV)
Common Stock^F1,F5	Oct 16, 2017	C	71,498	$0.00	A	71,498	I	By Trust
Common Stock^F1,F5	Oct 16, 2017	C	66,684	$0.00	A	138,182	I	By Trust
Common Stock^F1,F5	Oct 16, 2017	C	31,476	$0.00	A	169,658	I	By Trust
Common Stock^F5	Oct 16, 2017	C	12,936	$7.00	A	182,594	I	By Trust

Table II — derivative securities

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	D/I
Series C Preferred Stock^F1,F2	—	Oct 16, 2017	C	40,982	D	—	—	Common Stock	40,982	I
Series B Preferred Stock^F1,F3	—	Oct 16, 2017	C	31,747	D	—	—	Common Stock	31,747	I
Convertible Promissory Note^F6,F7,F4	$7.00	Oct 16, 2017	C	105,369	D	—	—	Common Stock	105,369	I
Series A Preferred Stock^F1,F4	—	Oct 16, 2017	C	479,145	D	—	—	Common Stock	479,145	I
Series B Preferred Stock^F1,F4	—	Oct 16, 2017	C	606,386	D	—	—	Common Stock	606,386	I
Series C Preferred Stock^F1,F4	—	Oct 16, 2017	C	888,690	D	—	—	Common Stock	888,690	I
Convertible Promissory Note^F6,F7,F5	$7.00	Oct 16, 2017	C	12,936	D	—	—	Common Stock	12,936	I
Series A Preferred Stock^F1,F5	—	Oct 16, 2017	C	66,684	D	—	—	Common Stock	66,684	I
Series B Preferred Stock^F1,F5	—	Oct 16, 2017	C	31,476	D	—	—	Common Stock	31,476	I
Series C Preferred Stock^F1,F5	—	Oct 16, 2017	C	71,498	D	—	—	Common Stock	71,498	I

Explanation of responses

F1The issuer's preferred stock will automatically convert into issuer's common stock on a one-to-one basis immediately prior to the closing of the issuer's initial public offering and has no expiration date.
F2Shares held by an irrevocable trust for the benefit of the reporting person's children of which the reporting person is a trustee. The reporting person disclaims any beneficial ownership in these shares.
F3Shares held by a limited partnership of which the reporting person is a trustee of a trust which is the general partner. The reporting person disclaims beneficial ownership in these shares except as to the reporting person's pecuniary interest therein.
F4Shares held by Sutter Hill Ventures, a California Limited Partnership. The reporting person is a managing director and member of the management committee of the general partner of Sutter Hill Ventures, a California Limited Partnership. The reporting person disclaims beneficial ownership in these shares except as to the reporting person's pecuniary interest therein.
F5Shares held by a trust of which the reporting person is a trustee. The reporting person disclaims beneficial ownership in these shares except as to the reporting person's pecuniary interest therein.
F6This reported amount represents the number of shares issuable upon the conversion of the principal and accrued interest of the convertible promissory note held by the reporting person.
F7The outstanding principal and accrued interest of the reporting person's convertible promissory note automatically converted 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 initial public offering upon closing of the initial public offering.