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*
SightLine Partners LLC

(Last) (First) (Middle)
8500 NORMANDALE LAKE BLVD., SUITE 1070

(Street)
BLOOMINGTON MN 55437

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
11/13/2018
3. Issuer Name and Ticker or Trading Symbol
VAPOTHERM INC [ VAPO ]
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 Convertible Preferred Stock (1) (1) Common Stock 372,206 (1) D
Series B Convertible Preferred Stock (2) (2) Common Stock 145,252 (2) D
Series C Convertible Preferred Stock (3) (3) Common Stock 430,937 (3) D
Series D Convertible Preferred Stock (4) (4) Common Stock 345,519 (4) D
Warrant to purchase Series A Convertible Preferred Stock (5) (5) Series A Convertible Preferred Stock 20,888 (5) D
1. Name and Address of Reporting Person*
SightLine Partners LLC

(Last) (First) (Middle)
8500 NORMANDALE LAKE BLVD., SUITE 1070

(Street)
BLOOMINGTON MN 55437

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
SightLine Healthcare Opportunity Fund II, L.P.

(Last) (First) (Middle)
8500 NORMANDALE LAKE BLVD., SUITE 1070

(Street)
BLOOMINGTON MN

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
SightLine Healthcare Opportunity Fund II-A, L.P.

(Last) (First) (Middle)
8500 NORMANDALE LAKE BLVD., SUITE 1070

(Street)
BLOOMINGTON MN 55437

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
SightLine Healthcare Opportunity Fund II-B, L.P.

(Last) (First) (Middle)
8500 NORMANDALE LAKE BLVD., SUITE 1070

(Street)
BLOOMINGTON MN 55437

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
SightLine Investors LLC

(Last) (First) (Middle)
8500 NORMANDALE LAKE BLVD., SUITE 1070

(Street)
BLOOMINGTON MN 55437

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
Explanation of Responses:
1. Series A Convertible Preferred Stock is convertible into shares of common stock at any time at the holder's election and automatically upon the consummation of a qualified public offering of the registrant. There is no expiration date for the Series A Convertible Preferred Stock. Consists of (i) 163,365 shares held by SightLine Healthcare Opportunity Fund II, (ii) 56,994 shares held by SightLine Healthcare Opportunity Fund II-A and (iii) 151,847 shares held by SightLine Healthcare Opportunity Fund II-B.
2. Series B Convertible Preferred Stock is convertible into shares of common stock at any time at the holder's election and automatically upon the consummation of a qualified public offering of the registrant. There is no expiration date for the Series B Convertible Preferred Stock. Consists of (i) 63,753 shares held by SightLine Healthcare Opportunity Fund II, (ii) 22,241 shares held by SightLine Healthcare Opportunity Fund II-A and (iii) 59,258 shares held by SightLine Healthcare Opportunity Fund II-B.
3. Series C Convertible Preferred Stock is convertible into shares of common stock at any time at the holder's election and automatically upon the consummation of a qualified public offering of the registrant. There is no expiration date for the Series C Convertible Preferred Stock. Consists of (i) 189,144 shares held by SightLine Healthcare Opportunity Fund II, (ii) 65,986 shares held by SightLine Healthcare Opportunity Fund II-A and (iii) 175,807 shares held by SightLine Healthcare Opportunity Fund II-B.
4. Series D Convertible Preferred Stock is convertible into shares of common stock at any time at the holder's election and automatically upon the consummation of a qualified public offering of the registrant. There is no expiration date for the Series D Convertible Preferred Stock. Consists of (i) 137,866 shares held by SightLine Healthcare Opportunity Fund II, (ii) 48,098 shares held by SightLine Healthcare Opportunity Fund II-A, (iii) 128,145 shares held by SightLine Healthcare Opportunity Fund II-B and (iv) 31,410 shares held by SightLine Investors, LLC.
5. The warrants to purchase Series A Convertible Preferred Stock are exercisable at any time at the holder's election, and have an expiration date of March 14, 2022. Consists of (i) warrants to purchase 9,168 shares held by SightLine Healthcare Opportunity Fund II, (ii) warrants to purchase 3,198 shares held by SightLine Healthcare Opportunity Fund II-A and (iii) warrants to purchase 8,522 shares held by SightLine Healthcare Opportunity Fund II-B.
Remarks:
Exhibit List Exhibit 24 - Power of Attorney
/s/ John Landry, as Attorney-In-Fact for SightLine Partners LLC 11/13/2018
/s/ John Landry, as Attorney-In-Fact for SightLine Healthcare Opportunity Fund II, L.P. 11/13/2018
/s/ John Landry, as Attorney-In-Fact for SightLine Healthcare Opportunity Fund II-A, L.P. 11/13/2018
/s/ John Landry, as Attorney-In-Fact for SightLine Healthcare Opportunity Fund II-B, L.P. 11/13/2018
/s/ John Landry, as Attorney-In-Fact for SightLine Investors, LLC 11/13/2018
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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