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
 
OMB APPROVAL
OMB Number: 3235-0104
Estimated average burden
hours per response: 0.5
1. Name and Address of Reporting Person*
WARBURG PINCUS LLC

(Last) (First) (Middle)
C/O WARBURG PINCUS LLC
450 LEXINGTON AVENUE

(Street)
NEW YORK NY 10017

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
09/14/2020
3. Issuer Name and Ticker or Trading Symbol
Outset Medical, Inc. [ OM ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X 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)
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 79,873 I(1)(3)(4)(5) See footnotes(1)(3)(4)(5)
Common Stock 2,496,681 I(2)(3)(4)(5) See footnotes(2)(3)(4)(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 Redeemable Convertible Preferred Stock (6) (6) Common Stock 117,283 (6) I(1)(3)(4)(5) See footnotes(1)(3)(4)(5)
Series A Redeemable Convertible Preferred Stock (6) (6) Common Stock 3,666,039 (6) I(2)(3)(4)(5) See footnotes(2)(3)(4)(5)
Series B Redeemable Convertible Preferred Stock (7) (7) Common Stock 41,587 (7) I(1)(3)(4)(5) See footnotes(1)(3)(4)(5)
Series B Redeemable Convertible Preferred Stock (7) (7) Common Stock 1,299,946 (7) I(2)(3)(4)(5) See footnotes(2)(3)(4)(5)
Series C Redeemable Convertible Preferred Stock (8) (8) Common Stock 22,713 (8) I(1)(3)(4)(5) See footnotes(1)(3)(4)(5)
Series C Redeemable Convertible Preferred Stock (8) (8) Common Stock 709,965 (8) I(2)(3)(4)(5) See footnotes(2)(3)(4)(5)
Series D Redeemable Convertible Preferred Stock (9) (9) Common Stock 16,655 (9) I(1)(3)(4)(5) See footnotes(1)(3)(4)(5)
Series D Redeemable Convertible Preferred Stock (9) (9) Common Stock 520,621 (9) I(2)(3)(4)(5) See footnotes(2)(3)(4)(5)
Explanation of Responses:
1. These securities are held directly by Warburg Pincus X Partners, L.P., a Delaware limited partnership ("WP X Partners").
2. These securities are held directly by WP X Finance, L.P., a Delaware limited partnership ("WP X Finance", and together with WP X Partners, the "WPP Funds"). WPX GP, L.P., a Delaware limited partnership ("WPX GP"), is the managing general partner of WP X Finance. Warburg Pincus Private Equity X, L.P., a Delaware limited partnership ("WP X"), is the general partner of WPX GP.
3. Warburg Pincus X, L.P., a Delaware limited partnership ("WP X LP"), is the general partner of WP X and WP X Partners. Warburg Pincus X GP L.P., a Delaware limited partnership ("WP X GP"), is the general partner of WP X LP. WPP GP LLC, a Delaware limited liability company ("WPP GP"), is the general partner of WP X GP. Warburg Pincus Partners, L.P., a Delaware limited partnership ("WP Partners"), is the managing member of WPP GP. Warburg Pincus Partners GP LLC, a Delaware limited liability company ("WP Partners GP"), is the general partner of WP Partners. Warburg Pincus & Co., a New York general partnership ("WP"), is the managing member of WP Partners GP. Warburg Pincus LLC, a New York limited liability company ("WP LLC"), is the manager of the WPP Funds.
4. Each of the WPP Funds, WPX GP, WP X, WP X LP, WP X GP, WPP GP, WP Partners, WP Partners GP, WP and WP LLC are collectively referred to herein as the "Warburg Pincus Entities."
5. Each of the Warburg Pincus Entities is a director-by-deputization solely for purposes of Section 16 of the Exchange Act.
6. Each share of Series A redeemable convertible preferred stock is convertible into approximately 0.0949 shares of common stock of the Issuer ("Shares"), and will automatically convert upon the closing of the issuer's initial public offering (the "IPO"). These shares have no expiration date.
7. Each share of Series B redeemable convertible preferred stock is convertible into approximately 0.1139 Shares, and will automatically convert upon the closing of the IPO. These shares have no expiration date.
8. Each share of Series C redeemable convertible preferred stock is convertible into approximately 0.1266 Shares, and will automatically convert upon the closing of the IPO. These shares have no expiration date.
9. Each share of Series D redeemable convertible preferred stock is convertible into approximately 0.1671 Shares, and will automatically convert upon the closing of the IPO. These shares have no expiration date.
Remarks:
Due to the limitations of the SEC EDGAR filing system, the WPP Funds, WPX GP, WP X, WP X LP, WP X GP, WPP GP, WP Partners, WP Partners GP, and WP are filing a separate Form 3 from WP LLC.
WARBURG PINCUS LLC By: /s/ Robert B. Knauss Name: Robert B. Knauss Title: Managing Director 09/14/2020
** 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.