SEC FORM 3

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^*

Buchanan Lucas W.

(Last)

(First)

(Middle)

C/O SILK ROAD MEDICAL, INC.

1213 INNSBRUCK DRIVE

(Street)

SUNNYVALE

94089

(City)

(State)

(Zip)

2. Date of Event Requiring Statement (Month/Day/Year)
04/03/2019

3. Issuer Name and Ticker or Trading Symbol
Silk Road Medical Inc [ SILK ]

4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

	Director	10% Owner
X	Officer (give title below)	Other (specify below)
	Chief Financial Officer

5. If Amendment, Date of Original Filed (Month/Day/Year)

6. Individual or Joint/Group Filing (Check Applicable Line)

X	Form filed by One Reporting Person
	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)
Common Stock	69,022	D

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)
1. Title of Derivative Security (Instr. 4)	Date Exercisable	Expiration Date	Title	Amount or Number of Shares	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)
Series C Preferred Stock	⁽¹⁾	⁽¹⁾	Common Stock	10,240	⁽¹⁾	D
Series C Preferred Stock	⁽¹⁾	⁽¹⁾	Common Stock	13,518	⁽¹⁾	I	See Footnote⁽²⁾
Employee Stock Option (Right to buy)	⁽³⁾	12/24/2024	Common Stock	7,408	$1.46	D
Employee Stock Option (Right to buy)	⁽³⁾	12/03/2025	Common Stock	226,995	$1.6	D
Employee Stock Option (Right to buy)	⁽⁴⁾	08/04/2026	Common Stock	50,000	$1.6	D
Employee Stock Option (Right to buy)	⁽⁵⁾	11/30/2027	Common Stock	86,157	$4.73	D
Employee Stock Option (Right to buy)	⁽⁵⁾	11/30/2027	Common Stock	33,689	$12.15	D
Employee Stock Option (Right to buy)	⁽⁶⁾	11/30/2027	Common Stock	25,847	$12.15	D
Employee Stock Option (Right to buy)	⁽³⁾	09/30/2026	Common Stock	398	$8.27	D

Explanation of Responses:

1. The Series C Preferred Stock shall automatically convert into Common Stock on a 1:1 basis immediately prior to the completion of the Issuer's initial public offering of Common Stock and has no expiration date.

2. These shares are held directly by the Buchanan Grandchildren's Irrevocable Trust, for which the Reporting Person serves as a co-trustee.

3. All of the shares subject to this option are fully vested and exercisable as of the date hereof.

4. One forty-eighth of the shares subject to the option vested on September 4, 2016 and one forty-eighth of the shares subject to the option vest each month thereafter, subject to the Reporting Person continuing as a service provider through each such date.

5. One forty-eighth of the shares subject to the option vested on September 1, 2017 and one forty-eighth of the shares subject to the option vest each month thereafter, subject to the Reporting Person continuing as a service provider through each such date.

6. All of the shares subject to the option shall vest upon the earlier of a change in control of the Issuer or the two year anniversary of the initial public offering of the Issuer's Common Stock, subject to the Reporting Person continuing as a service provider through such date.

Remarks:

Exhibit 24 - Power of Attorney

	/s/ Mhairi Jones, by power of attorney	04/03/2019
	** 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).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.