Filing Details

Accession Number:
0001104659-18-031876
Form Type:
4
Zero Holdings:
No
Publication Time:
2018-05-09 21:46:27
Reporting Period:
2018-05-02
Accepted Time:
2018-05-09 21:46:27
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
1199894 C Marilyn Nelson C/O Inspire Medical Systems, Inc.
9700 63Rd Avenue North, Suite 200
Maple Grove MN 55369
Yes No No 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 79,023 $0.00 195,259 No 4 C Indirect By LLC
Common Stock Acquisiton 2018-05-07 85,371 $0.00 280,630 No 4 C Indirect By LLC
Common Stock Acquisiton 2018-05-07 103,477 $0.00 384,107 No 4 C Indirect By LLC
Common Stock Acquisiton 2018-05-07 46,013 $0.00 430,120 No 4 C Indirect By LLC
Common Stock Acquisiton 2018-05-07 63,514 $0.00 493,634 No 4 C Indirect By LLC
Common Stock Acquisiton 2018-05-07 75,317 $0.00 568,951 No 4 C Indirect By LLC
Common Stock Acquisiton 2018-05-07 62,500 $16.00 631,451 No 4 P Indirect By LLC
Equity Swap Involved Form Type Code Nature of Ownership Explanation
No 4 C Indirect By LLC
No 4 C Indirect By LLC
No 4 C Indirect By LLC
No 4 C Indirect By LLC
No 4 C Indirect By LLC
No 4 C Indirect By LLC
No 4 P Indirect By LLC
Reported Derivative Transactions
Sec. Name Sec. Type Acquisiton - Disposition Date Amount Price Amount - 2 Price - 2
Common Stock Series A Convertible Preferred Stock Disposition 2018-05-07 525,507 $0.00 79,023 $0.00
Common Stock Series B Convertible Preferred Stock Disposition 2018-05-07 460,325 $0.00 85,371 $0.00
Common Stock Series C Convertible Preferred Stock Disposition 2018-05-07 688,122 $0.00 103,477 $0.00
Common Stock Series D Convertible Preferred Stock Disposition 2018-05-07 305,993 $0.00 46,013 $0.00
Common Stock Series E Convertible Preferred Stock Disposition 2018-05-07 367,577 $0.00 63,514 $0.00
Common Stock Series F Convertible Preferred Stock Disposition 2018-05-07 500,863 $0.00 75,317 $0.00
Common Stock Employee Stock Option (right to buy) Acquisiton 2018-05-02 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
0 No 4 C Indirect
0 No 4 C Indirect
0 No 4 C Indirect
0 No 4 C Indirect
0 No 4 C Indirect
17,296 2028-05-02 No 4 A Direct
Footnotes
  1. Shares of Series A, Series C, Series D and 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 ("IPO") 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, the "Certificate of Incorporation")). These shares had no expiration date.
  2. Shares of Series B Convertible Preferred Stock automatically converted into shares of the Issuer's Common Stock at a 1-for-0.1855 conversion rate immediately prior to the closing of the Issuer's IPO for no additional consideration (subject to the payment of cash in lieu of any fractional shares in accordance with the Issuer's Certificate of Incorporation). These shares had no expiration date.
  3. Shares of Series E Convertible Preferred Stock automatically converted into shares of the Issuer's Common Stock at a 1-for-0.1728 conversion rate immediately prior to the closing of the Issuer's IPO for no additional consideration (subject to the payment of cash in lieu of any fractional shares in accordance with the Issuer's Certificate of Incorporation). These shares had no expiration date.
  4. Shares held by GDN Holdings, LLC, of which the Reporting Person is the managing member.
  5. 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.