0001536647-22-000002.txt : 20220504 0001536647-22-000002.hdr.sgml : 20220504 20220504144411 ACCESSION NUMBER: 0001536647-22-000002 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20220504 DATE AS OF CHANGE: 20220504 EFFECTIVENESS DATE: 20220504 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Aerin Medical Inc. CENTRAL INDEX KEY: 0001536647 IRS NUMBER: 452572453 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-444391 FILM NUMBER: 22891088 BUSINESS ADDRESS: STREET 1: 2565 LEGHORN STREET CITY: MOUNTAIN VIEW STATE: CA ZIP: 94043 BUSINESS PHONE: (650) 605-3579 MAIL ADDRESS: STREET 1: 2565 LEGHORN STREET CITY: MOUNTAIN VIEW STATE: CA ZIP: 94043 FORMER COMPANY: FORMER CONFORMED NAME: Aerin Medical, Inc. DATE OF NAME CHANGE: 20111207 D 1 primary_doc.xml X0708 D LIVE 0001536647 Aerin Medical Inc. 2565 Leghorn Street Mountain View CA CALIFORNIA 94043 (650) 605-3579 DELAWARE Aerin Medical, Inc. Corporation true Scott Wolf 2565 Leghorn Street Mountain View CA CALIFORNIA 94043 Executive Officer Matthew Brokaw 2565 Leghorn Street Mountain View CA CALIFORNIA 94043 Executive Officer Director Bill McClellan 2565 Leghorn Street Mountain View CA CALIFORNIA 94043 Executive Officer Karen Long 2565 Leghorn Street Mountain View CA CALIFORNIA 94043 Director William Facteau 2565 Leghorn Street Mountain View CA CALIFORNIA 94043 Director David Thrower 2565 Leghorn Street Mountain View CA CALIFORNIA 94043 Director Kevin Reilly 2565 Leghorn Street Mountain View CA CALIFORNIA 94043 Director Ryan Drant 2565 Leghorn Street Mountain View CA CALIFORNIA 94043 Director John White 2565 Leghorn Street Mountain View CA CALIFORNIA 94043 Director Gregory Garfield 2565 Leghorn Street Mountain View CA CALIFORNIA 94043 Director Fred Dinger 2565 Leghorn Street Mountain View CA CALIFORNIA 94043 Executive Officer Other Health Care Decline to Disclose 06b false 2022-04-28 false true false 0 60000000 34880478 25119522 false 2 0 0 0 false Aerin Medical Inc. /s/ MATTHEW BROKAW Matthew Brokaw President & CEO 2022-05-03