Filing Details

Accession Number:
0001104659-18-031860
Form Type:
4
Zero Holdings:
No
Publication Time:
2018-05-09 21:16:12
Reporting Period:
2018-05-02
Accepted Time:
2018-05-09 21:16:12
SEC Url:
Form 4 Filing
Issuer
Cik Name Symbol Sector (SIC) IRS No
1609550 Inspire Medical Systems Inc. INSP () 4
Insiders
Cik Name Reported Address Insider Title Director Officer Large Shareholder Other
1459212 Joyce Erony C/O Inspire Medical Systems, Inc.
9700 63Rd Avenue North, Suite 200
Maple Grove MN 55369
Yes No Yes No
Reported Non-Derivative Transactions
Sec. Name Acquisiton - Disposition Date Amount Price Remaning Holdings Equity Swap Involved Form Type Code Nature of Ownership Explanation
Common Stock Acquisiton 2018-05-07 1,372,043 $0.00 1,372,043 No 4 C Indirect See Footnote
Common Stock Acquisiton 2018-05-07 125,000 $16.00 1,497,043 No 4 P Indirect See Footnote
Equity Swap Involved Form Type Code Nature of Ownership Explanation
No 4 C Indirect See Footnote
No 4 P Indirect See Footnote
Reported Derivative Transactions
Sec. Name Sec. Type Acquisiton - Disposition Date Amount Price Amount - 2 Price - 2
Common Stock Series F Convertible Preferred Stock Disposition 2018-05-07 9,124,088 $0.00 1,372,043 $0.00
Common Stock Employee Stock Option (right to buy) Acquisiton 2015-05-02 17,296 $0.00 17,296 $16.00
Remaning Holdings Exercise Date Expiration Date Equity Swap Involved Transaction Form Type Transaction Code Nature of Ownership
0 No 4 C Indirect
17,296 2028-05-02 No 4 A Direct
Footnotes
  1. Shares of Series F Convertible Preferred Stock automatically converted into shares of the Issuer's Common Stock at a 1-for-0.1504 conversion rate immediately prior to the closing of the Issuer's initial public offering for no additional consideration (subject to the payment of cash in lieu of any fractional shares in accordance with the Issuer's Sixth Amended and Restated Certificate of Incorporation, as amended). These shares had no expiration date.
  2. These shares are held of record by Amzak Health Investors, LLC ("Amzak Health"). Joyce Erony, a director of the Issuer, Michael D. Kazma, and Anders Hove are managers of Amzak Health and, as a result, have shared voting and dispositive power over the shares held by Amzak Health. Ms. Erony disclaims beneficial ownership of the shares held by Amzak Health except to the extent of her proportionate pecuniary interest therein.
  3. The option vests and becomes exercisable on May 2, 2019, subject to the Reporting Person's continuous service to the Issuer through such date. The option was erroneously included on the Reporting Person's Form 3 filed on May 2, 2018.