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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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| Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
| 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 control number. | SEC 1474 (9-02) | ||
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1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) |
4. Transaction Code (Instr. 8) |
5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4, and 5) |
6. Date Exercisable and Expiration Date (Month/Day/Year) |
7. Title and Amount of Underlying Securities (Instr. 3 and 4) |
8. Price of Derivative Security (Instr. 5) |
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) |
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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| Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
| Stock Option (right to buy) | $ 1.66 | 06/22/2023 | A | 385,500 | (5) | 06/22/2032 | Common Stock | 385,500 | $ 0 | 385,500 | D | ||||
| Reporting Owner Name / Address | Relationships | |||
| Director | 10% Owner | Officer | Other | |
| Nelson Todd Robert C/O TELESIS BIO INC. 10431 WATERIDGE CIRCLE, SUITE 150 SAN DIEGO, CA 92121 |
X | X | Chief Executive Officer | |
| /s/ Rob Cutler, as Attorney-in-Fact | 03/05/2024 | |
| **Signature of Reporting Person | Date |
| * | If the form is filed by more than one reporting person, see Instruction 4(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). |
| (1) | The Reporting Person was granted restricted stock units ("RSUs"), which represent a contingent right to receive one share of Issuer's Common Stock for each RSU. Subject to the Reporting Person's continuing as a Service Provider (as defined in the Issuer's 2021 Stock Incentive Plan (the "Plan")) through each applicable vesting date, 25% of the RSUs shall vest on each of March 1, 2024, March 1, 2025, March 1, 2026, and March 1, 2027. |
| (2) | Represents the number of shares withheld by the Issuer to satisfy the tax withholding obligation in connection with the vesting of RSUs. |
| (3) | Shares held of record by GATTACA Mining LLC ("GATTACA"). The Reporting Person is the managing member of GATTACA and may be deemed to have voting and dispositive power over the shares held by GATTACA. |
| (4) | Shares held of record by M-185 Corporation ("M-185"). The Reporting Person is the majority owner of M-185 and may be deemed to have voting and dispositive power over the shares held by M-185. |
| (5) | Subject to the Reporting Person's continuing as a Service Provider (as defined in the Plan) through each applicable vesting date, twenty-five percent (25%) of the shares subject to the option shall vest on March 1, 2024, and one thirty-sixth (1/36th) of the remaining shares subject to the option shall vest each month thereafter. |