Ownership Submission
|
FORM 4
|
|
Check this box if no longer subject to Section 16, Form 4 or Form 5 obligations may continue. See Instruction 1(b).
|
|
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549STATEMENT OF CHANGES IN 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:3235-0287Expires:January 31, 2005Estimated average burden hours per response...0.5
|
|
|
1. Name and Address of Reporting Person *
|
|
TSINGOS CHRISTINE A
|
|
2. Issuer Name and Ticker or Trading Symbol
Telesis Bio Inc. [TBIO]
|
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
|
_____ Director
|
_____ 10% Owner
|
|
_____ Officer (give title below)
|
_____ Other (specify below)
|
|
|
|
|
(Last)
|
(First)
|
(Middle)
|
|
C/O TELESIS BIO INC. , 10431 WATERIDGE CIRCLE, SUITE 150
|
|
3. Date of Earliest Transaction (Month/Day/Year)
|
(Street)
|
|
SAN DIEGO
|
CA
|
92121
|
|
4. If Amendment, Date Original Filed(Month/Day/Year)
|
6. Individual or Join/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 Acquired, Disposed of, or Beneficially Owned
|
|
|
1.Title of Security
|
2. Transaction Date (Month/Day/Year)
|
2A. Deemed Execution Date, if any (Month/Day/Year)
|
3. Transaction Code
|
4. Securities Acquired (A) or Disposed of (D)
|
5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
|
6. Ownership Form: Direct (D) or Indirect (I)
|
7. Nature of Indirect Beneficial Ownership
|
|
Code
|
V
|
Amount
|
(A) or (D)
|
Price
|
|
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
(e.g., puts, calls, warrants, options, convertible securities)
|
1. Title of Derivate Security
|
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
|
5. Number of Derivative Securities Acquired (A) or Disposed of (D)
|
6. Date Exercisable and Expiration Date
|
7. Title and Amount of Securities Underlying Derivative Security
|
8. Price of Derivative Security
|
9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s)
|
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
|
11. Nature of Indirect Beneficial Ownership
|
|
Code
|
V
|
(A)
|
(D)
|
Date Exercisable
|
Expriation Date
|
Title
|
Amount or Number of Shares
|
Reporting Owners
|
Reporting Owner Name / Address
|
Relationships
|
|
Director
|
10% Owner
|
Officer
|
Other
|
TSINGOS CHRISTINE A
C/O TELESIS BIO INC.
10431 WATERIDGE CIRCLE, SUITE 150
SAN DIEGO, CA92121
|
|
|
|
|
Signatures
|
/s/ Christine Tsingos
|
2024-05-03
|
|
**Signature of Reporting Person
|
Date
|
Explanation of Responses:
|
(*)
|
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).
|
|
(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 continuing as a Service Provider (as defined in the Issuer's 2021 Stock Incentive Plan (the "Plan")) through such date, 100% of the RSUs shall vest on the earlier of the one-year anniversary of the date of grant or on the date of the annual meeting of the Issuer's stockholders following the date of grant.
|
|
(2)
|
The Reporting Person was granted RSUs, which represent a contingent right to receive one share of Issuer's Common Stock for each RSU. Subject to the Reporting Person continuing as a Service Provider (as defined in the Plan) through each applicable date, 16,868 of the RSUs shall vest on January 1, 2025, and 20,241 of the RSUs shall vest on the earlier of the one-year anniversary of the date of grant or on the date of the annual meeting of the Issuer's stockholders following the date of grant.
|
|
(3)
|
Subject to the Reporting Person continuing as a Service Provider (as defined in the Plan) through such date, 100% of the shares subject to the option shall vest on the earlier of the one-year anniversary of the date of grant or on the date of the annual meeting of the Issuer's stockholders following the date of grant.
|
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient,
See Instruction 6 for procedure.Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB number.
