# EDGAR Filing Document

**Accession Number:** 0001820515
**File Stem:** 0001104659-23-040185
**Filing Date:** 2023-3
**Character Count:** 15183
**Document Hash:** 511157c26c4f370cd6d8c3f4ec045707
**Contains OCR:** False
**Source Format:** 

## Filing Content

## Filing Summary
**0001104659-23-040185.hdr.sgml**: 20230331

**ACCESSION NUMBER**: 0001104659-23-040185

**CONFORMED SUBMISSION TYPE**: SC 13G

**PUBLIC DOCUMENT COUNT**: 1

**FILED AS OF DATE**: 20230331

**DATE AS OF CHANGE**: 20230331

**GROUP MEMBERS**: GARY W. ROLLINS VOTING TRUST U/A DATED SEPTEMBER 14, 1994

**GROUP MEMBERS**: LOR, INC.

**GROUP MEMBERS**: RFT INVESTMENT COMPANY, LLC

**SUBJECT COMPANY**: 

**COMPANY DATA:**
- **COMPANY CONFORMED NAME:** Ra Medical Systems, Inc.
- **CENTRAL INDEX KEY:** 0001716621
- **STANDARD INDUSTRIAL CLASSIFICATION:** SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841]
- **IRS NUMBER:** 383661826
- **STATE OF INCORPORATION:** DE
- **FISCAL YEAR END:** 1231

**FILING VALUES:**
- **FORM TYPE:** SC 13G
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 005-90844
- **FILM NUMBER:** 23787852

**BUSINESS ADDRESS:**
- **STREET 1:** 1670 HIGHWAY 160 WEST
- **STREET 2:** SUITE 205
- **CITY:** FORT MILL
- **STATE:** SC
- **ZIP:** 29708
- **BUSINESS PHONE:** 973-691-2000

**MAIL ADDRESS:**
- **STREET 1:** 1670 HIGHWAY 160 WEST
- **STREET 2:** SUITE 205
- **CITY:** FORT MILL
- **STATE:** SC
- **ZIP:** 29708
**FILED BY**: 

**COMPANY DATA:**
- **COMPANY CONFORMED NAME:** R. Randall Rollins Voting Trust U/A dated August 25, 1994
- **CENTRAL INDEX KEY:** 0001820515
- **IRS NUMBER:** 586437967
- **STATE OF INCORPORATION:** GA
- **FISCAL YEAR END:** 1231

**FILING VALUES:**
- **FORM TYPE:** SC 13G

**BUSINESS ADDRESS:**
- **STREET 1:** C/O RFA MANAGEMENT COMPANY, LLC
- **STREET 2:** 1908 CLIFF VALLEY WAY NE
- **CITY:** ATLANTA
- **STATE:** GA
- **ZIP:** 30329
- **BUSINESS PHONE:** 4044864628

**MAIL ADDRESS:**
- **STREET 1:** C/O RFA MANAGEMENT COMPANY, LLC
- **STREET 2:** 1908 CLIFF VALLEY WAY NE
- **CITY:** ATLANTA
- **STATE:** GA
- **ZIP:** 30329

**UNITED STATES<br> SECURITIES AND EXCHANGE COMMISSION<br> Washington, D.C. 20549**

**SCHEDULE 13G**

**Under the Securities Exchange Act of 1934**

---

| |
|:---|
| Ra Medical Systems, Inc. |
| (Name of Issuer) |
| Common Stock, $0.0001 Par Value |
| (Title of Class of Securities) |
| 74933X302 |
| (CUSIP Number) |
| W. Keith Wilkes, Jr. |
| c/o RFA Management Company, LLC |
| 1908 Cliff Valley Way N.E. |
| Atlanta, GA 30329 |
| with a copy to: |
| Eric Orsic |
| McDermott Will & Emery LLP |
| 444 West Lake Street, Suite 4000 |
| Chicago, IL 60606 |
| (312) 372-2000 |
| (Name, Address and Telephone Number of Person Authorized to Receive Notices and Communications) |
| March 21, 2023 |
| (Date of Event Which Requires Filing of this Statement) |

---

Check the appropriate box to designate the rule pursuant to which this Schedule is filed:

a. ◻ Rule 13d-1(b)

b. ⌧ Rule 13d-1(c)

c. ◻ Rule 13d-1(d)

\*The remainder of this cover page shall be filled out for a reporting person's initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter the disclosures provided in a prior cover page.

The information required in the remainder of this cover page shall not be deemed to be "filed" for the purpose of Section 18 of the Securities Exchange Act of 1934 ("Act") or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes).

---

| | |
|:---|:---|
| 1. | Names of Reporting Persons. |
|  | Gary W. Rollins Voting Trust U/A dated September 14, 1994 |
| 2. | Check the Appropriate Box if a Member of a Group (See Instructions) |
|  | (a) ⌧ |
|  | (b) ◻ |
| 3. | SEC Use Only |
| 4. | Citizenship or Place of Organization <br> United States |

---

---

| | | |
|:---|:---|:---|
| Number of<br> Shares Beneficially<br> Owned by Each<br> Reporting<br> Person With: | 5. Sole Voting Power | 0 |
|  | 6. Shared Voting Power | 261553 (1) |
|  | 7. Sole Dispositive Power | 0 |
|  | 8. Shared Dispositive Power | 261553 (1) |

---

---

| | |
|:---|:---|
| 9. | Aggregate Amount Beneficially Owned by Each Reporting Person |
|  | 261553 (1) |
| 10. | Check if the Aggregate Amount in Row (9) Excludes Certain Shares (See Instructions) |
| 11. | Percent of Class Represented by Amount in Row (9) **5.25%** |
| 12. | Type of Reporting Person (See Instructions) |
|  | OO |

---

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(1) Includes 261,553 shares of Common Stock held by RFT Investment Company, LLC. The Gary W. Rollins Voting Trust U/A dated September 14, 1994 (the "GWR Voting Trust") has a 50% voting interest in LOR, Inc., which is the manager of RFT Investment Company, LLC. Does not include 1,165,949 shares of Common Stock that may be issued upon conversion of 1,165.949 shares of Series X Preferred Stock held by RFT Investment Company LLC which may not be converted, at the earliest, until July 9, 2024. The reporting person disclaims beneficial ownership of these shares except to the extent of the reporting person's pecuniary interest.

---

| | |
|:---|:---|
| 1. | Names of Reporting Persons. |
|  | R. Randall Rollins Voting Trust U/A dated August 25, 1994 |
| 2. | Check the Appropriate Box if a Member of a Group (See Instructions) |
|  | (a) ⌧ |
|  | (b) ◻ |
| 3. | SEC Use Only |
| 4. | Citizenship or Place of Organization <br> United States |

---

---

| | | |
|:---|:---|:---|
| Number of<br> Shares Beneficially<br> Owned by Each<br> Reporting<br> Person With: | 5. Sole Voting Power | 0 |
|  | 6. Shared Voting Power | 261553 (1) |
|  | 7. Sole Dispositive Power | 0 |
|  | 8. Shared Dispositive Power | 261553 (1) |

---

---

| | |
|:---|:---|
| 9. | Aggregate Amount Beneficially Owned by Each Reporting Person |
|  | 261553 (1) |
| 10. | Check if the Aggregate Amount in Row (9) Excludes Certain Shares (See Instructions) |
| 11. | Percent of Class Represented by Amount in Row (9) **5.25%** |
| 12. | Type of Reporting Person (See Instructions) |
|  | OO |

---

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(1) Includes 261,553 shares of Common Stock held by RFT Investment Company, LLC. The R. Randall Rollins Voting Trust U/A dated August 25, 1994 (the "RRR Voting Trust") has a 50% voting interest in LOR, Inc., which is the manager of RFT Investment Company, LLC. Does not include 1,165,949 shares of Common Stock that may be issued upon conversion of 1,165.949 shares of Series X Preferred Stock held by RFT Investment Company LLC which may not be converted, at the earliest, until July 9, 2024. The reporting person disclaims beneficial ownership of these shares except to the extent of the reporting person's pecuniary interest.

---

| | |
|:---|:---|
| 1. | Names of Reporting Persons. |
|  | LOR, Inc. |
| 2. | Check the Appropriate Box if a Member of a Group (See Instructions) |
|  | (a) ⌧ |
|  | (b) ◻ |
| 3. | SEC Use Only |
| 4. | Citizenship or Place of Organization <br> Georgia |

---

]

---

| | | |
|:---|:---|:---|
| Number of<br> Shares Beneficially<br> Owned by Each<br> Reporting<br> Person With: | 5. Sole Voting Power | 0 |
|  | 6. Shared Voting Power | 261553 (1) |
|  | 7. Sole Dispositive Power | 0 |
|  | 8. Shared Dispositive Power | 261553 (1) |

---

---

| | |
|:---|:---|
| 9. | Aggregate Amount Beneficially Owned by Each Reporting Person |
|  | 261553 (1) |
| 10. | Check if the Aggregate Amount in Row (9) Excludes Certain Shares (See Instructions) |
| 11. | Percent of Class Represented by Amount in Row (9) **5.25%** |
| 12. | Type of Reporting Person (See Instructions) |
|  | CO |

---

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(1) Includes 261,553 shares of Common Stock held by RFT Investment Company, LLC. LOR, Inc. is the manager of RFT Investment Company, LLC. Does not include 1,165,949 shares of Common Stock that may be issued upon conversion of 1,165.949 shares of Series X Preferred Stock held by RFT Investment Company LLC which may not be converted, at the earliest, until July 9, 2024. The reporting person disclaims beneficial ownership of these shares except to the extent of the reporting person's pecuniary interest.

---

| | |
|:---|:---|
| 1. | Names of Reporting Persons. |
|  | RFT Investment Company, LLC |
| 2. | Check the Appropriate Box if a Member of a Group (See Instructions) |
|  | (a) ⌧ |
|  | (b) ◻ |
| 3. | SEC Use Only |
| 4. | Citizenship or Place of Organization <br> Georgia |

---

---

| | | |
|:---|:---|:---|
| Number of<br> Shares Beneficially<br> Owned by Each<br> Reporting<br> Person With: | 5. Sole Voting Power | 261553 (1) |
|  | 6. Shared Voting Power | 0 |
|  | 7. Sole Dispositive Power | 261553 (1) |
|  | 8. Shared Dispositive Power | 0 |

---

---

| | |
|:---|:---|
| 9. | Aggregate Amount Beneficially Owned by Each Reporting Person |
|  | 261553 |
| 10. | Check if the Aggregate Amount in Row (9) Excludes Certain Shares (See Instructions) |
| 11. | Percent of Class Represented by Amount in Row (9) **5.25%** |
| 12. | Type of Reporting Person (See Instructions) |
|  | OO |

---

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(1) Does not include 1,165,949 shares of Common Stock that may be issued upon conversion of 1,165.949 shares of Series X Preferred Stock held by RFT Investment Company LLC which may not be converted, at the earliest, until July 9, 2024. The reporting person disclaims beneficial ownership of these shares except to the extent of the reporting person's pecuniary interest.

**Item 1(a). Name of Issuer:**

Ra Medical Systems, Inc. (the "Issuer")

**Item 1(b). Address of Issuer's Principal Executive Offices:**

1670 Highway 160 West

Suite 205

Fort Mill, SC 29708

**Item 2(a). Name of Person Filing:**

Gary W. Rollins Voting Trust U/A dated September 14, 1994 (the "GWR Voting Trust")

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;R. Randall Rollins Voting Trust U/A dated August 25, 1994 (the "RRR Voting Trust")

LOR, Inc.

RFT Investment Company, LLC

**Item 2(b). Address of Principal Business Offices or, if none, Residence:**

GWR Voting Trust

c/o RFA Management Company, LLC

1908 Cliff Valley Way, NE

Atlanta, Georgia 30329

RRR Voting Trust

c/o RFA Management Company, LLC

1908 Cliff Valley Way, NE

Atlanta, Georgia 30329

LOR, Inc.

c/o RFA Management Company, LLC

1908 Cliff Valley Way, NE

Atlanta, Georgia 30329

RFT Investment Company, LLC

c/o RFA Management Company, LLC

1908 Cliff Valley Way, NE

Atlanta, Georgia 30329

**Item 2(c). Citizenship:**

GWR Voting Trust – United States

RRR Voting Trust – United States

LOR, Inc. – Georgia

RFT Investment Company, LLC – Georgia

**Item 2(d). Title of Class of Securities:**

Common Stock, $0.0001 Par Value

**Item 2(e). CUSIP Number:**

74933X302

**Item 3. If this statement is filed pursuant to §§240.13d-1(b) or 240.13d-2(b) or (c), check whether the person filing is a:**

Not applicable.

**Item 4. Ownership.**

Provide the following information regarding the aggregate number and percentage of the class of securities of the issuer identified in Item 1.

(a), (b), and (c):

The information as of the date of the event which requires filing of this statement required by Items 4(a) – (c) is set forth in Rows 5 – 11 of the cover page for the Reporting Person hereto and is incorporated herein by reference. The percentage set forth in Row 11 of the cover page for the Reporting Person is based on 4,984,093 shares of the Common Stock issued and outstanding as of March 23, 2023 as reported in the Issuer's Form 10-K for the fiscal year ended December 31, 2022 filed with the Securities and Exchange Commission on March 28, 2023.

**Item 5. Ownership of Five Percent or Less of a Class.**

Not applicable.

**Item 6. Ownership of More than Five Percent on Behalf of Another Person.**

Not applicable.

**Item 7. Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on by the Parent Holding Company.**

Not applicable

**Item 8. Identification and Classification of Members of the Group.**

Not applicable

**Item 9. Notice of Dissolution of Group.**

Not applicable

**Item 10. Certification**

By signing below I certify that, to the best of my knowledge and belief, the securities referred to above were not acquired and are not held for the purpose of or with the effect of changing or influencing the control of the issuer of the securities and were not acquired and are not held in connection with or as a participant in any transaction having that purpose or effect, other than activities solely in connection with a nomination under §240.14a-11.

**SIGNATURE**

After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct.

---

| | | |
|:---|:---|:---|
| By: | /s/ TIMOTHY C. ROLLINS | Date: March 31, 2023 |
|  | TIMOTHY C. ROLLINS |  |
|  | **As Co-Trustee of the R. RANDALL ROLLINS VOTING TRUST U/A DATED AUGUST 25, 1994,** and | **As Co-Trustee of the R. RANDALL ROLLINS VOTING TRUST U/A DATED AUGUST 25, 1994,** and |
|  | **As Co-Trustee of the GARY W. ROLLINS VOTING TRUST U/A DATED SEPTEMBER 14, 1994**, and | **As Co-Trustee of the GARY W. ROLLINS VOTING TRUST U/A DATED SEPTEMBER 14, 1994**, and |
|  | As Vice President of |  |
|  | **LOR, INC.**, and |  |
|  | As Vice President of LOR, Inc., in its capacity as Manager of |  |
|  | **RFT INVESTMENT COMPANY, LLC** |  |

---

**<u>EXHIBIT A</u>**

**Joint Filing Agreement**

In accordance with Rule 13d-1(k) promulgated under the Securities Exchange Act of 1934, as amended, each of the persons named below agrees to the joint filing of this Amendment to Schedule 13G, including further amendments thereto, with respect to the shares of Common Stock, $0.0001 par value per share, of Ra Medical Systems, Inc. and further agrees that this Joint Filing Agreement be filed with the Securities and Exchange Commission as an exhibit to such filing; provided, however, that no person shall be responsible for the completeness or accuracy of the information concerning the other persons making the filing unless such person knows or has reason to believe such information is inaccurate (as provided in Rule 13d-1(k)(1)(ii)). This Joint Filing Agreement may be executed in one or more counterparts, all of which together shall constitute one and the same instrument.

IN WITNESS WHEREOF, the persons named below have executed this Joint Filing Agreement as of the date set forth below.

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| | | |
|:---|:---|:---|
| By: | /s/ TIMOTHY C. ROLLINS | Date: March 31, 2023 |
|  | TIMOTHY C. ROLLINS |  |
|  | **As Co-Trustee of the R. RANDALL ROLLINS VOTING TRUST U/A DATED AUGUST 25, 1994,** and | **As Co-Trustee of the R. RANDALL ROLLINS VOTING TRUST U/A DATED AUGUST 25, 1994,** and |
|  | **As Co-Trustee of the GARY W. ROLLINS VOTING TRUST U/A DATED SEPTEMBER 14, 1994**, and | **As Co-Trustee of the GARY W. ROLLINS VOTING TRUST U/A DATED SEPTEMBER 14, 1994**, and |
|  | As Vice President of |  |
|  | **LOR, INC.**, and |  |
|  | As Vice President of LOR, Inc., in its capacity as Manager of |  |
|  | **RFT INVESTMENT COMPANY, LLC** |  |

---