Gilde Healthcare IV Management B.V. Form 4 Inari Medical / Gilde Healthcare IV U.A. Cooperatieve ownership change

SEC Form 4

FORM 4

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940

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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).

1. Name and Address of Reporting Person^*

Cooperatieve Gilde Healthcare IV U.A.

(Last)

(First)

(Middle)

NEWTONLAAN 91 3584 BP

(Street)

UTRECHT

(City)

(State)

(Zip)

2. Issuer Name and Ticker or Trading Symbol
Inari Medical, Inc. [ NARI ]

5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

Director	X	10% Owner
Officer (give title below)		Other (specify below)

3. Date of Earliest Transaction (Month/Day/Year)
05/27/2020

4. If Amendment, Date of Original Filed (Month/Day/Year)

6. Individual or Joint/Group Filing (Check Applicable Line)

	Form filed by One Reporting Person
X	Form filed by More than One Reporting Person

Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3)	2. Transaction Date (Month/Day/Year)	2A. Deemed Execution Date, if any (Month/Day/Year)	3. Transaction Code (Instr. 8)		4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5)			5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)	6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	7. Nature of Indirect Beneficial Ownership (Instr. 4)
1. Title of Security (Instr. 3)	2. Transaction Date (Month/Day/Year)	2A. Deemed Execution Date, if any (Month/Day/Year)	Code	V	Amount	(A) or (D)	Price		6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	7. Nature of Indirect Beneficial Ownership (Instr. 4)
Common Stock	05/27/2020		P		342,329	A	$19	342,329	I	See footnote⁽¹⁾
Common Stock	05/27/2020		C		7,599,350⁽²⁾	A	⁽²⁾	7,941,679	I	See footnote⁽¹⁾

Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3)	2. Conversion or Exercise Price of Derivative Security	3. Transaction Date (Month/Day/Year)	3A. Deemed Execution Date, if any (Month/Day/Year)	4. Transaction Code (Instr. 8)		5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)		6. Date Exercisable and Expiration Date (Month/Day/Year)		7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4)		8. Price of Derivative Security (Instr. 5)	9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)	10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	11. Nature of Indirect Beneficial Ownership (Instr. 4)
1. Title of Derivative Security (Instr. 3)	2. Conversion or Exercise Price of Derivative Security	3. Transaction Date (Month/Day/Year)	3A. Deemed Execution Date, if any (Month/Day/Year)	Code	V	(A)	(D)	Date Exercisable	Expiration Date	Title	Amount or Number of Shares	8. Price of Derivative Security (Instr. 5)		10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	11. Nature of Indirect Beneficial Ownership (Instr. 4)
Series C Preferred Stock	⁽²⁾	05/27/2020		C			7,599,350	⁽²⁾	⁽²⁾	Common Stock	7,599,350	⁽²⁾	0	I	See footnote⁽¹⁾

1. Name and Address of Reporting Person^*

Cooperatieve Gilde Healthcare IV U.A.

(Last)

(First)

(Middle)

NEWTONLAAN 91 3584 BP

(Street)

UTRECHT

(City)

(State)

(Zip)

1. Name and Address of Reporting Person^*

Gilde Healthcare IV Management B.V.

(Last)

(First)

(Middle)

NEWTONLAAN 91 3584 BP

(Street)

UTRECHT

(City)

(State)

(Zip)

1. Name and Address of Reporting Person^*

Gilde Healthcare Holding B.V.

(Last)

(First)

(Middle)

NEWTONLAAN 91 3584 BP

(Street)

UTRECHT

(City)

(State)

(Zip)

Explanation of Responses:

1. All securities reported are held of record by Cooperatieve Gilde Healthcare IV U.A. ("Gilde"). Gilde is managed by Gilde Healthcare IV Management B.V. ("Management"). Management is owned by Gilde Healthcare Holding B.V. ("Holding"). Each of Management and Holding may be deemed to have voting, investment and dispositive power with respect to the securities held by Gilde. Each of Management and Holding disclaims beneficial ownership of these securities and this report shall not be deemed an admission that any of them is the beneficial owner of such securities, except to the extent of their respective pecuniary interests therein.

2. Upon the closing of the Issuer's initial public offering, each share of preferred stock automatically converted into shares of the Issuer's common stock on a one-for-one basis.

Remarks:

	Cooperatieve Gilde Healthcare IV U.A., By: /s/ Mitchell Hill, Name: Mitchell Hill, Title: Attorney-in-Fact	05/27/2020
	Gilde Healthcare IV Management B.V., By: /s/ Mitchell Hill, Name: Mitchell Hill, Title: Attorney-in-Fact	05/27/2020
	Gilde Healthcare Holding B.V., By: /s/ Mitchell Hill, Name: Mitchell Hill, Title: Attorney-in-Fact	05/27/2020
	** Signature of Reporting Person	Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).
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Gilde Healthcare IV Management B.V. Form 4Inari Medical / Gilde Healthcare IV U.A. Cooperatieve ownership change