Inari Medical (NARI) Form 3 Initial statement of insider ownership

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^*

Versant Ventures IV, LLC

(Last) (First) (Middle)

ONE SANSOME

SUITE 3630

(Street)

SAN FRANCISCO CA 94104

(City) (State) (Zip)

2. Date of Event Requiring Statement (Month/Day/Year)
05/21/2020

3. Issuer Name and Ticker or Trading Symbol
Inari Medical, Inc. [ NARI ]

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

Director	X	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)

	Form filed by One Reporting Person
X	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)

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
Series A Preferred Stock	(1)	(1)	Common Stock	3,571,426	(1)	I	See footnote(2)(3)
Series B Preferred Stock	(1)	(1)	Common Stock	1,197,058	(1)	I	See footnote(3)(4)
Series C Preferred Stock	(1)	(1)	Common Stock	977,058	(1)	I	See footnote(3)(5)

1. Name and Address of Reporting Person^*

Versant Ventures IV, LLC

(Last) (First) (Middle)

ONE SANSOME

SUITE 3630

(Street)

SAN FRANCISCO CA 94104

(City) (State) (Zip)

1. Name and Address of Reporting Person^*

Versant Venture Capital IV, L.P.

(Last) (First) (Middle)

ONE SANSOME

SUITE 3630

(Street)

SAN FRANCISCO CA 94104

(City) (State) (Zip)

1. Name and Address of Reporting Person^*

Versant Side Fund IV, L.P.

(Last) (First) (Middle)

ONE SANSOME

SUITE 3630

(Street)

SAN FRANCISCO CA 94104

(City) (State) (Zip)

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.

Remarks:

	Versant Ventures IV, LLC, By: /s/ Robin L. Praeger, its managing director	05/21/2020
	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
	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
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