Sec Form 3 Filing - Versant Ventures IV, LLC @ Inari Medical, Inc. - 2020-05-21

Insider filing report for Changes in Beneficial Ownership
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FORM 3
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
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, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
Versant Ventures IV, LLC
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)
(Last) (First) (Middle)
ONE SANSOME, SUITE 3630
3. Date of Earliest Transaction (MM/DD/YY)
05/21/2020
(Street)
SAN FRANCISCO, CA94104
4. If Amendment, Date Original Filed (MM/DD/YY)
6. Individual or Joint/Group Filing (Check Applicable Line)
_____ Form filed by One Reporting Person
__ X __ Form filed by More than One Reporting Person
(City) (State) (Zip)
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Transaction Date (MM/DD/YY) 2A. Deemed Execution Date, if any (MM/DD/YY) 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
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 (MM/DD/YY) 3A. Deemed Execution Date, if any (MM/DD/YY) 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
(MM/DD/YY)
7. Title and Amount of Underlying Securities
(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 of Derivative Security: 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 ) ( 1 ) ( 1 ) Common Stock 3,571,426 I See footnote ( 2 ) ( 3 )
Series B Preferred Stock ( 1 ) ( 1 ) ( 1 ) Common Stock 1,197,058 I See footnote ( 3 ) ( 4 )
Series C Preferred Stock ( 1 ) ( 1 ) ( 1 ) Common Stock 977,058 I See footnote ( 3 ) ( 5 )
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Versant Ventures IV, LLC
ONE SANSOME
SUITE 3630
SAN FRANCISCO, CA94104
X
Versant Venture Capital IV, L.P.
ONE SANSOME
SUITE 3630
SAN FRANCISCO, CA94104
X
Versant Side Fund IV, L.P.
ONE SANSOME
SUITE 3630
SAN FRANCISCO, CA94104
X
Signatures
Versant Ventures IV, LLC, By: /s/ Robin L. Praeger, its managing director 05/21/2020
Signature of Reporting Person Date
Versant Venture Capital IV, L.P., By: /s/ Versant Ventures IV, LLC, its general partner, By: Robin L. Praeger, its managing director 05/21/2020
Signature of Reporting Person Date
Versant Side Fund IV, L.P., By: /s/ Versant Ventures IV, LLC, its general partner, By: Robin L. Praeger, its managing director 05/21/2020
Signature of Reporting Person Date
Explanation of Responses:
( 1 )Each share of the Issuer's preferred stock is convertible on a one-to-one basis into shares of the Issuer's common stock at the holder's election and has no expiration date. The preferred stock will automatically convert into common stock upon the closing of the Issuer's initial public offering.
( 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 )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. 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 3 is being filed separately by Mr. Nielsen in his capacity as a director of the Issuer.
( 4 )Includes (i) 1,189,565 shares held of record by Versant Capital and (ii) 7,493 shares held of record by Versant Side.
( 5 )Includes (i) 970,942 shares held of record by Versant Capital and (ii) 6,116 shares held of record by Versant Side.

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* If the form is filed by more than one reporting person, see Instruction 4(b)(v).
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