Amzak Health Investors Form 3 Inspire Medical Systems / Anders D Hove 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^*

Amzak Health Investors, LLC

(Last) (First) (Middle)

980 FEDERAL HIGHWAY, SUITE 315

(Street)

BOCA RATON FL 33432

(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)

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 F Convertible Preferred Stock	(1)	(1)	Common Stock	1,372,043	(2)	D(3)

1. Name and Address of Reporting Person^*

Amzak Health Investors, LLC

(Last) (First) (Middle)

980 FEDERAL HIGHWAY, SUITE 315

(Street)

BOCA RATON FL 33432

(City) (State) (Zip)

1. Name and Address of Reporting Person^*

Hove Anders D

(Last) (First) (Middle)

980 FEDERAL HIGHWAY, SUITE 315

(Street)

BOCA RATON FL 33432

(City) (State) (Zip)

1. Name and Address of Reporting Person^*

Kazma Michael D

(Last) (First) (Middle)

980 FEDERAL HIGHWAY, SUITE 315

(Street)

BOCA RATON FL 33432

(City) (State) (Zip)

Explanation of Responses:

1. Shares of Series F Convertible Preferred Stock have no expiration date and are convertible, at the option of the holder, into shares of Common Stock at the then-effective conversion rate 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")). The shares of Series F Convertible Preferred Stock will automatically convert into shares of Common Stock at the then-effective conversion rate for no additional consideration (subject to the payment of cash in lieu of any fractional shares in accordance with the Certificate of Incorporation) immediately prior to the closing of the Issuer's initial public offering.

2. The Series F Convertible Preferred Stock is convertible into shares of Common Stock at a 1-for-0.1504 conversion rate.

3. These shares are held of record by Amzak Health Investors, LLC ("Amzak Health"). Joyce Erony, a director of the Issuer, Michael D. Kazma and Anders Hove are managers of Amzak Health and, as a result, have shared voting and dispositive power over the shares held by Amzak Health. Each of Ms. Erony and Messrs. Kazma and Hove disclaim beneficial ownership of the shares held by Amzak Health except to the extent of his or her proportionate pecuniary interest therein.

Remarks:

Exhibit List: Exhibit 24 - Power of Attorney

	/s/ Richard Buchholz, Attorney-in-Fact for Amzak Health Investors, LLC	05/02/2018
	/s/ Richard Buchholz, Attorney-in-Fact for Michael D. Kazma	05/02/2018
	/s/ Richard Buchholz, Attorney-in-Fact for Anders Hove	05/02/2018
	** Signature of Reporting Person	Date
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