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*
Versant Ventures IV, LLC

(Last) (First) (Middle)
ONE SANSOME
SUITE 3630

(Street)
SAN FRANCISCO CA 94104

(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)
Code V Amount (A) or (D) Price
Common Stock 05/27/2020 C 5,745,542(1) A (1) 5,745,542 I See footnote(2)(3)(4)(5)
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)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Series A Preferred Stock (1) 05/27/2020 C 3,571,426 (1) (1) Common Stock 3,571,426 (1) 0 I See footnote(2)(5)
Series B Preferred Stock (1) 05/27/2020 C 1,197,058 (1) (1) Common Stock 1,197,058 (1) 0 I See footnote(3)(5)
Series C Preferred Stock (1) 05/27/2020 C 977,058 (1) (1) Common Stock 977,058 (1) 0 I See footnote(4)(5)
1. Name and Address of Reporting Person*
Versant Ventures IV, LLC

(Last) (First) (Middle)
ONE SANSOME
SUITE 3630

(Street)
SAN FRANCISCO CA 94104

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Versant Venture Capital IV, L.P.

(Last) (First) (Middle)
ONE SANSOME
SUITE 3630

(Street)
SAN FRANCISCO CA 94104

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Versant Side Fund IV, L.P.

(Last) (First) (Middle)
ONE SANSOME
SUITE 3630

(Street)
SAN FRANCISCO CA 94104

(City) (State) (Zip)
Explanation of Responses:
1. 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.
2. Includes (i) 3,549,070 shares held of record by Versant Venture Capital IV, L.P. ("Versant Capital") and (ii) 22,356 shares held of record by Versant Side Fund IV, L.P. ("Versant Side").
3. Includes (i) 1,189,565 shares held of record by Versant Capital and (ii) 7,493 shares held of record by Versant Side.
4. Includes (i) 970,942 shares held of record by Versant Capital and (ii) 6,116 shares held of record by Versant Side.
5. Versant Ventures IV, LLC ("VV IV") is the general partner of each of Versant Capital and Versant Side and, as a result, may be deemed to share voting and dispositive power over the shares held by each of Versant Capital and Versant Side and disclaims beneficial ownership of such securities except to the extent of its pecuniary interest therein. Each of Brian Atwood, Bradley J. Bolzon, Samuel Colella, Ross Jaffe, William Link, Kirk G. Nielsen, Robin L. Praeger, Rebecca Robertson, Charles Warden and Tom Woiwode Ph.D., as managing members of VV IV, may be deemed to share voting and dispositive power over the shares held by Versant Capital and Versant Side and disclaim beneficial ownership of such securities except to the extent of their respective pecuniary interest therein. A Form 4 is being filed separately by Mr. Nielsen in his capacity as a director of the Issuer.
Remarks:
Versant Ventures IV, LLC, By: /s/ Robin L. Praeger, its managing director 05/27/2020
Versant Venture Capital IV, L.P., By: /s/ Versant Ventures IV, LLC, its general partner, By: Robin L. Praeger, its managing director 05/27/2020
Versant Side Fund IV, L.P., By: /s/ Versant Ventures IV, LLC, its general partner, By: Robin L. Praeger, its managing director 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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