McCormick Shawn Form 3 Inspire Medical Systems / Shawn McCormick ownership change

SEC Form 3

FORM 3

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940

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1. Name and Address of Reporting Person^*

McCormick Shawn

(Last) (First) (Middle)

C/O INSPIRE MEDICAL SYSTEMS, INC.

9700 63RD AVENUE NORTH, SUITE 200

(Street)

MAPLE GROVE MN 55369

(City) (State) (Zip)

2. Date of Event Requiring Statement (Month/Day/Year)
05/02/2018

3. Issuer Name and Ticker or Trading Symbol
Inspire Medical Systems, Inc. [ INSP ]

4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

X	Director	10% Owner
	Officer (give title below)	Other (specify below)

5. If Amendment, Date of Original Filed (Month/Day/Year)

6. Individual or Joint/Group Filing (Check Applicable Line)

X	Form filed by One Reporting Person
	Form filed by More than One Reporting Person

Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4)	2. Amount of Securities Beneficially Owned (Instr. 4)	3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5)	4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock	7,518	D

Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4)	2. Date Exercisable and Expiration Date (Month/Day/Year)		3. Title and Amount of Securities Underlying Derivative Security (Instr. 4)		4. Conversion or Exercise Price of Derivative Security	5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5)	6. Nature of Indirect Beneficial Ownership (Instr. 5)
	Date Exercisable	Expiration Date	Title	Amount or Number of Shares
Stock Option (Right to Buy)	(1)	01/01/2027	Common Stock	7,518	0.94	D
Stock Option (Right to Buy)	(2)	04/01/2027	Common Stock	7,518	0.94	D
Stock Option (Right to Buy)	(3)	05/02/2028	Common Stock	17,296	16	D

Explanation of Responses:

1. The option vests and becomes exercisable as to 50% of the underlying shares on January 1, 2018 and the remaining 50% of the underlying shares on January 1, 2019.

2. The option vests and becomes exercisable as to 50% of the underlying shares on April 1, 2018 and the remaining 50% of the underlying shares on April 1, 2019.

3. The option vests and becomes exercisable on May 2, 2019, subject to the Reporting Person's continuous service to the Issuer through such date; provided the option will not vest if the Issuer's initial public offering does not close.

Remarks:

Exhibit List: Exhibit 24 - Power of Attorney

	/s/ Richard Buchholz, as Attorney-in-Fact for Shawn T McCormick	05/02/2018
	** Signature of Reporting Person	Date
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 5 (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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