Filing Details

Accession Number:
0001104659-21-004714
Form Type:
13G Filing
Publication Date:
2021-01-14 19:00:00
Filed By:
Eguchi Kouji
Company:
Medirom Healthcare Technologies Inc.
Filing Date:
2021-01-15
SEC Url:
13G Filing
Ownership Summary

Please notice the below summary table is generated without human intervention and may contain errors. Please refer to the complete filing displayed below for exact figures.

Name Sole Voting Power Shared Voting Power Sole Dispositive Power Shared Dispositive Power Aggregate Amount Owned Power Percent of Class
Kouji Eguchi 1,884,960 0 1,884,960 0 1,884,960 37.3%
Filing

 

 

UNITED STATES
SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

 


 

SCHEDULE 13G

 

Under the Securities Exchange Act of 1934

(Amendment No.    )*

 


 

Medirom Healthcare Technologies Inc.

(Name of Issuer)

 

American depositary shares, each representing one common share, no par value

(Title of Class of Securities)

 

58510H103

(CUSIP Number)

 

December 31, 2020

(Date of Event Which Requires Filing of this Statement)

 

Check the appropriate box to designate the rule pursuant to which this Schedule is filed.

  o

Rule 13d-1(b)

  o

Rule 13d-1(c)

  x

Rule 13d-1(d)

 

*                 The remainder of this cover page shall be filled out for a reporting persons initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter the disclosures provided in a prior cover page.

 

The information required on the remainder of this cover page shall not be deemed to be filed for the purpose of Section 18 of the Securities Exchange Act of 1934 (Act) or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes).

 

 

 


 

SCHEDULE 13G

 

 CUSIP No.  58510H103

 

 

 

1

NAME OF REPORTING PERSONS

 

Kouji Eguchi

2

CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (See Instructions)

 

(a)  ¨

(b)  ¨

3

SEC USE ONLY

4

CITIZENSHIP OR PLACE OF ORGANIZATION

 

Japan

NUMBER OF

SHARES

BENEFICIALLY

OWNED BY

EACH

REPORTING

PERSON

WITH

5

SOLE VOTING POWER

 

1,884,960

6

SHARED VOTING POWER

 

0

7

SOLE DISPOSITIVE POWER

 

1,884,960

8

SHARED DISPOSITIVE POWER

 

0

9

AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON

 

1,884,960

10

CHECK IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES (See Instructions)

o

11

PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9)

 

37.3% (1)

12

TYPE OF REPORTING PERSON (See Instructions)

 

IN

 


(1)    This percentage is based on 4,022,500 common shares outstanding and 229,500 shares of common stock subject to options that are currently exercisable, which are deemed to be outstanding and to be beneficially owned by the person holding the options for the purpose of computing the percentage ownership of that person but are not treated as outstanding for the purpose of computing the percentage ownership of any other person, following the issuers initial public offering according to the issuers prospectus as filed with the Securities and Exchange Commission on December 31, 2020.

 

2


 

SCHEDULE 13G

 

 CUSIP No.  58510H103

 

 

 

 

Item 1.

 

 

(a)         Name of Issuer

 

Medirom Healthcare Technologies Inc.

 

(b)         Address of Issuers principal executive offices

 

2-3-1 Daiba, Minato-ku

Tokyo 135-0091, Japan

 

 

Item 2.

 

 

(a)         Name of persons filing

 

Kouji Eguchi

 

(b)         Address or principal business office or, if none, residence

 

2-3-1 Daiba, Minato-ku

Tokyo 135-0091, Japan

 

(c)          Citizenship

 

Japan

 

(d)         Title of class of securities

 

American depositary shares, each representing one common share of the issuer, no par value

 

(e)          CUSIP No.

 

58510H103

 

 

Item 3.

If this statement is filed pursuant to §§240.13d-1(b) or 240.13d-2(b) or (c), check whether the person filing is a:

 

 

 

(a)

 

¨

 

Broker or dealer registered under section 15 of the Act (15 U.S.C. 78o).

 

 

 

 

 

 

 

(b)

¨

Bank as defined in section 3(a)(6) of the Act (15 U.S.C. 78c).

(c)

¨

Insurance company as defined in section 3(a)(19) of the Act (15 U.S.C. 78c).

(d)

¨

Investment company registered under section 8 of the Investment Company Act of 1940 (15 U.S.C. 80a-8).

(e)

¨

An investment adviser in accordance with §240.13d-1(b)(1)(ii)(E);

(f)

¨

An employee benefit plan or endowment fund in accordance with §240.13d-1(b)(1)(ii)(F);

(g)

¨

A parent holding company or control person in accordance with §240.13d-1(b)(1)(ii)(G);

(h)

¨

A savings associations as defined in Section 3(b) of the Federal Deposit Insurance Act (12 U.S.C. 1813);

(i)

¨

A church plan that is excluded from the definition of an investment company under section 3(c)(14) of the Investment Company Act of 1940 (15 U.S.C. 80a-3);

(j)

¨

A non-U.S. institution in accordance with § 240.13d-1(b)(1)(ii)(J);

 

 

 

 

 

 

 

 

 

(k)

 

¨

 

Group, in accordance with §240.13d-1(b)(1)(ii)(K). If filing as a non-U.S. institution in accordance with § 240.13d-1(b)(1)(ii)(J), please specify the type of institution:

 

3


 

SCHEDULE 13G

 

 CUSIP No. 58510H103

 

 

 

 

Item 4.

Ownership.

 

(a)

Amount beneficially owned:

1,884,960

 

 

 

 

 

(b)

Percent of class:

37.3%

 

 

 

 

 

(c)

Number of shares as to which the person has:

 

 

 

 

 

 

 

(i)

Sole power to vote or to direct the vote:

1,884,960

 

 

(ii)

Shared power to vote or to direct the vote:

0

 

 

(iii)

Sole power to dispose or to direct the disposition of:

1,884,960

 

 

(iv)

Shared power to dispose or to direct the disposition of:

0

 

 

Item 5.

Ownership of 5 Percent or Less of a Class.

 

Not applicable.

 

Item 6.

Ownership of More than 5 Percent on Behalf of Another Person.

 

Not applicable.

 

Item 7.

Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on by the Parent Holding Company or Control Person.

 

Not applicable.

 

Item 8.

Identification and Classification of Members of the Group.

 

Not applicable.

 

 

Item 9.

Notice of Dissolution of Group.

 

Not applicable.

 

 

Item 10.

Certification.

 

Not applicable.

 

4


 

SCHEDULE 13G

 

 CUSIP No. 58510H103

 

 

 

SIGNATURES

 

After reasonable inquiry and to the best of the undersigneds knowledge and belief, the undersigned certifies that the information set forth in this statement is true, complete and correct.

 

Dated:  January 15, 2021

 

 

 

 

 

 

Signature:

/s/ Kouji Eguchi

 

Name:

Kouji Eguchi

 

5