Filing Details

Accession Number:
0001441372-10-000004
Form Type:
4
Zero Holdings:
No
Publication Time:
2010-12-21 12:07:43
Reporting Period:
2010-12-16
Filing Date:
2010-12-21
Accepted Time:
2010-12-21 12:07:43
SEC Url:
Form 4 Filing
Issuer
Cik Name Symbol Sector (SIC) IRS No
1496268 Reva Medical Inc. RVA Orthopedic, Prosthetic & Surgical Appliances & Supplies (3842) 330810505
Insiders
Cik Name Reported Address Insider Title Director Officer Large Shareholder Other
1441372 Saints Capital Everest Lp 475 Sansome Street
Suite 1850
San Francisco CA 94111
No 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 2010-12-16 1,204,180 $0.00 1,204,180 No 4 C Direct
Common Stock Acquisiton 2010-12-16 102,883 $0.00 1,307,063 No 4 C Direct
Common Stock Acquisiton 2010-12-16 17,147 $6.51 1,324,210 No 4 X Direct
Common Stock Disposition 2010-12-16 10,185 $10.95 1,314,025 No 4 F Direct
Common Stock Acquisiton 2010-12-16 3,430 $6.51 1,317,455 No 4 X Direct
Common Stock Disposition 2010-12-16 2,037 $10.95 1,315,418 No 4 F Direct
Common Stock Acquisiton 2010-12-16 3,158,164 $6.51 4,473,582 No 4 C Direct
Common Stock Acquisiton 2010-12-16 90,909 $1.10 4,564,491 No 4 P Direct
Equity Swap Involved Form Type Code Nature of Ownership Explanation
No 4 C Direct
No 4 C Direct
No 4 X Direct
No 4 F Direct
No 4 X Direct
No 4 F Direct
No 4 C Direct
No 4 P Direct
Reported Derivative Transactions
Sec. Name Sec. Type Acquisiton - Disposition Date Amount Price Amount - 2 Price - 2
Common Stock Series G-1 Preferred Stock Disposition 2010-12-16 1,204,180 $0.00 1,204,180 $0.00
Common Stock Series H Preferred Stock Disposition 2010-12-16 102,883 $0.00 102,883 $0.00
Common Stock Warrant (right to buy) Disposition 2010-12-16 17,147 $0.00 17,147 $6.51
Common Stock Warrant (right to buy) Disposition 2010-12-16 3,430 $0.00 3,430 $6.51
Common Stock Convertible Note Disposition 2010-12-16 3,146,911 $0.00 3,146,911 $6.51
Remaning Holdings Exercise Date Expiration Date Equity Swap Involved Transaction Form Type Transaction Code Nature of Ownership
0 No 4 C Direct
0 No 4 C Direct
0 2010-05-25 2012-12-07 No 4 X Direct
0 2010-06-02 2012-12-07 No 4 X Direct
0 2005-06-08 2011-12-31 No 4 C Direct
Footnotes
  1. Each share of Series G-1 Preferred Stock was automatically converted into 1.187321 shares of Common Stock upon closing of the Issuer's initial public offering.
  2. Each share of Series H Preferred Stock was automatically converted into one share of Common Stock upon the closing of the Issuer's initial public offering.
  3. The Series G-1 and H Preferred Stock have no expiration date.
  4. Reflects the cashless exercise of the warrant, resulting in the issuance to the Reporting Person of 6,962 shares of common stock and cancellation of the warrant with respect to the balance of 10,185 shares of common stock.
  5. Reflects the cashless exercise of the warrant, resulting in the issuance to the Reporting Person of 1,393 shares of common stock and cancellation of the warrant with respect to the balance of 2,037 shares of common stock.
  6. The outstanding principal and accrued and unpaid interest on these convertible promissory notes automatically converted into shares of common stock upon the closing of the Issuer's initial public offering, at $6.5066 per share.
  7. Represents the U.S. dollar price paid for 90,909 shares of common stock purchased on the Australian Stock Exchange in the form of Chess Depositary Interests ("CDIs") on December 16, 2010. The purchaser price per CDI of $1.10 was calculated using the Aus.$/U.S.$ exchange rate on December 7, 2010 of 0.9983.