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* Presidio Management Group X LLC (Last) (First) (Middle) 1460 EL CAMINO REAL, SUITE 100 (Street) MENLO PARK CA 94025 (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	2,307,142	(1)	I	Directly Owned by USVP X(2)
Series A Preferred Stock	(1)	(1)	Common Stock	73,809	(1)	I	Directly Owned by AFF X(2)
Series B Preferred Stock	(1)	(1)	Common Stock	2,899,876	(1)	I	Directly Owned by USVP X(2)
Series B Preferred Stock	(1)	(1)	Common Stock	92,771	(1)	I	Directly Owned by AFF X(2)
Series C Preferred Stock	(1)	(1)	Common Stock	2,278,331	(1)	I	Directly Owned by USVP X(2)
Series C Preferred Stock	(1)	(1)	Common Stock	72,887	(1)	I	Directly Owned by AFF X(2)

1. Name and Address of Reporting Person* Presidio Management Group X LLC (Last) (First) (Middle) 1460 EL CAMINO REAL, SUITE 100 (Street) MENLO PARK CA 94025 (City) (State) (Zip)

1. Name and Address of Reporting Person* US VENTURE PARTNERS X LP (Last) (First) (Middle) 1460 EL CAMINO REAL, SUITE 100 (Street) MENLO PARK CA 94025 (City) (State) (Zip)

1. Name and Address of Reporting Person* USVP X AFFILIATES LP (Last) (First) (Middle) 1460 EL CAMINO REAL, SUITE 100 (Street) MENLO PARK CA 94025 (City) (State) (Zip)

1. Name and Address of Reporting Person* FEDERMAN IRWIN (Last) (First) (Middle) 1460 EL CAMINO REAL, SUITE 100 (Street) MENLO PARK CA 94025 (City) (State) (Zip)

1. Name and Address of Reporting Person* KRAUSZ STEVEN M (Last) (First) (Middle) 1460 EL CAMINO REAL, SUITE 100 (Street) MENLO PARK CA 94025 (City) (State) (Zip)

1. Name and Address of Reporting Person* Lewis Richard W. (Last) (First) (Middle) 1460 EL CAMINO REAL, SUITE 100 (Street) MENLO PARK CA 94025 (City) (State) (Zip)

1. Name and Address of Reporting Person* Matteucci Paul A (Last) (First) (Middle) 1460 EL CAMINO REAL, SUITE 100 (Street) MENLO PARK CA 94025 (City) (State) (Zip)

1. Name and Address of Reporting Person* Tansey Casey M (Last) (First) (Middle) 1460 EL CAMINO REAL, SUITE 100 (Street) MENLO PARK CA 94025 (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. The reported securities are owned directly by each of U.S. Venture Partners X, L.P. ("USVP X") and USVP X Affiliates Fund, L.P. ("AFF X") (together, the "USVP X Funds"). Presidio Management Group X, L.L.C. ("PMG X") is the general partner of each of the USVP X Funds and may be deemed to have sole voting and dispositive power over the reported securities held by the USVP X Funds. Jonathan D. Root, a director of the issuer, Irwin Federman, Steven Krausz, Richard Lewis, Paul Matteucci and Casey Tansey are the managing members of PMG X, who may be deemed to share voting and dispositive power over the reported securities held by the USVP X Funds. Such persons and entities disclaim beneficial ownership of the reported securities held by the USVP X Funds, except to the extent of any pecuniary interest therein

Remarks:

Exhibit List: Exhibit 24 - Power of Attorney

	Presidio Management Group X, L.L.C., By: /s/ Dale Holladay - Attorney in Fact	05/21/2020
	U.S. Venture Partners X, L.P, By: /s/ Dale Holladay - Attorney in Fact	05/21/2020
	USVP X Affiliates, L.P, By: /s/ Dale Holladay - Attorney in Fact	05/21/2020
	Irwin Federman, By: /s/ Dale Holladay - Attorney in Fact	05/21/2020
	Steven M Krausz, By: /s/ Dale Holladay - Attorney in Fact	05/21/2020
	Richard W. Lewis, By: /s/ Dale Holladay - Attorney in Fact	05/21/2020
	Paul Matteucci, By: /s/ Dale Holladay - Attorney in Fact	05/21/2020
	Casey M. Tansey, By: /s/ Dale Holladay - Attorney in Fact	05/21/2020
	** Signature of Reporting Person	Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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