Annual Statement of Changes in Beneficial Ownership (5)
24 Gennaio 2020 - 10:07PM
Edgar (US Regulatory)
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
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Form 3 Holdings Reported
[X]
Form 4 Transactions Reported
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0362
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1.0
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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
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3x5 Partners, LLC | 2. Issuer Name and Ticker or Trading SymbolVAPOTHERM INC [VAPO] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director __X__ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
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(Last)
(First)
(Middle)
2540 NE MARTIN LUTHER KING JR. BLVD. | 3. Statement for Issuer's Fiscal Year Ended (MM/DD/YYYY)
12/31/2019 |
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(Street)
PORTLAND, OR 97212
(City)
(State)
(Zip)
| 4. If Amendment, Date Original Filed(MM/DD/YYYY)
| 6. Individual or Joint/Group Filing(Check Applicable Line)
___ Form Filed by One Reporting Person
_X_ Form Filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security
(Instr. 3) | 2. Trans. Date | 2A. Deemed Execution Date, if any | 3. Trans. 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) |
| Amount | (A) or (D) | Price |
| Common Stock | 8/2/2019 | | P4 | 10000 | A | $14.34 (1) | 10000 | D | |
| Common Stock | 9/11/2019 | | P4 | 20000 | A | $8.68 (2) | 30000 | D | |
| Common Stock | | | | | | | 2294204 | I | By Vapotherm Investors, LLC (3) |
| Common Stock | | | | | | | 1049958 | I | By 3x5 Special Opportunity Fund, L.P. (3) |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
(Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any | 4. Trans. 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/YYYY) | 7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4) | 8. Price of Derivative Security
(Instr. 5) | 9. Number of Derivative Securities Beneficially Owned at End of Issuer's Fiscal Year
(Instr. 4) | 10. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 4) | 11. Nature of Indirect Beneficial Ownership
(Instr. 4) |
| (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
| Explanation of Responses: |
| (1) | This transaction was executed in multiple trades at prices ranging from $14.325 to $14.35. The price reported above reflects the weighted average price. The Reporting Person hereby undertakes to provide upon request to the staff of the Securities and Exchange Commission, the Issuer or a security holder of the Issuer full information regarding the number of shares and prices at which the transaction was effected. |
| (2) | This transaction was executed in multiple trades at prices ranging from $8.64 to $8.74. The price reported above reflects the weighted average price. The Reporting Person hereby undertakes to provide upon request to the staff of the Securities and Exchange Commission, the Issuer or a security holder of the Issuer full information regarding the number of shares and prices at which the transaction was effected. |
| (3) | 3x5 Partners, LLC is the managing member of Vapotherm Investors, LLC and a member of 3x5 Special Opportunity Partners, LLC, which is the general partner of 3x5 Special Opportunity Fund, L.P., and by virtue of these relationships 3x5 Partners, LLC may be deemed to indirectly beneficially own the shares directly held by Vapotherm Investors, LLC and 3x5 Special Opportunity Partners, L.P. 3x5 Partners, LLC disclaims beneficial ownership, within the meaning of Section 16 of the Securities Exchange Act of 1934, as amended, or otherwise, of such securities except to the extent of its pecuniary interest therein. |
Reporting Owners
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| Reporting Owner Name / Address | Relationships |
| Director | 10% Owner | Officer | Other |
3x5 Partners, LLC
2540 NE MARTIN LUTHER KING JR. BLVD.
PORTLAND, OR 97212 |
| X |
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3x5 Special Opportunity Fund, L.P.
101 S. HANLEY ROAD, SUITE 1850
ST. LOUIS, MO 63105 |
| X |
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Vapotherm Investors, LLC
2540 NE MARTIN LUTHER KING JR. BLVD.
PORTLAND, OR 97212 |
| X |
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Signatures
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| /s/Anthony Ten Haagen, as Attorney In Fact for 3x5 Partners, LLC, Vapotherm Investors, LLC and 3x5 Special Opportunity Fund, L.P. | | 1/24/2020 |
| **Signature of Reporting Person | Date |
Grafico Azioni Vapotherm (QX) (USOTC:VAPO)
Storico
Da Nov 2024 a Dic 2024
Grafico Azioni Vapotherm (QX) (USOTC:VAPO)
Storico
Da Dic 2023 a Dic 2024
