Sec Form 3 Filing - MOLL FREDERIC H @ ShockWave Medical, Inc. - 2019-03-06

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
MOLL FREDERIC H
2. Issuer Name and Ticker or Trading Symbol
ShockWave Medical, Inc. [ SWAV]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X __ Director _____ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
(Last) (First) (Middle)
C/O SHOCKWAVE MEDICAL, INC., 5403 BETSY ROSS DRIVE
3. Date of Earliest Transaction (MM/DD/YY)
03/06/2019
(Street)
SANTA CLARA, CA95054
4. If Amendment, Date Original Filed (MM/DD/YY)
6. Individual or Joint/Group Filing (Check Applicable Line)
__ X __ Form filed by One Reporting Person
_____ 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 Convertible Preferred Stock ( 5 ) ( 4 ) ( 4 ) Common Stock 123,657 D
Series A-1 Convertible Preferred Stock ( 5 ) ( 4 ) ( 4 ) Common Stock 114,109 D
Series B Convertible Preferred Stock ( 5 ) ( 4 ) ( 4 ) Common Stock 28,767 D
Series C Convertible Preferred Stock ( 5 ) ( 4 ) ( 4 ) Common Stock 24,347 D
Stock Option (Right to Buy) $ 0.488 ( 1 ) 12/09/2021 Common Stock 12,295 D
Stock Option (Right to Buy) $ 0.61 ( 2 ) 02/24/2024 Common Stock 81,967 D
Stock Option (Right to Buy) $ 2.196 ( 3 ) 06/16/2025 Common Stock 16,393 D
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
MOLL FREDERIC H
C/O SHOCKWAVE MEDICAL, INC.
5403 BETSY ROSS DRIVE
SANTA CLARA, CA95054
X
Signatures
/s/ Trinh Phung, as attorney-in-fact for Frederic Moll 03/06/2019
Signature of Reporting Person Date
Explanation of Responses:
( 1 )Fully vested.
( 2 )Fully vested.
( 3 )Twenty-Five percent of the shares subject to the option vested on 5/20/16 and the balance of the shares shall vest in equal monthly installments thereafter for 36 months.
( 4 )The securities are preferred stock of the Issuer. These securities are convertible upon the closing of the Issuer's initial public offering and do not have an expiration date.
( 5 )Each share of preferred stock will automatically convert on a 1-for-1 basis into common stock upon the closing of the Issuer's initial public offering.

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).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).

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