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*
Delphi Management Partners VIII, L.L.C.

(Last) (First) (Middle)
3000 SAND HILL ROAD,
BUILDING 1, SUITE 135

(Street)
MENLO PARK CA 94025

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
11/13/2013
3. Issuer Name and Ticker or Trading Symbol
TANDEM DIABETES CARE INC [ TNDM ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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)
Form filed by One Reporting Person
X 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)
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 C Preferred Stock (1) (2) Common Stock 664,565 $0.00 I See footnote(3)
Series C Preferred Stock (1) (2) Common Stock 6,488 $0.00 I See footnote(4)
Series D Preferred Stock (1) (2) Common Stock 2,967,987 $0.00 I See footnote(3)
Series D Preferred Stock (1) (2) Common Stock 28,979 $0.00 I See footnote(4)
1. Name and Address of Reporting Person*
Delphi Management Partners VIII, L.L.C.

(Last) (First) (Middle)
3000 SAND HILL ROAD,
BUILDING 1, SUITE 135

(Street)
MENLO PARK CA 94025

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
DELPHI VENTURES VIII LP

(Last) (First) (Middle)
3000 SAND HILL ROAD
BUILDING 1, SUITE 135

(Street)
MENLO PARK CA 94025

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
Delphi BioInvestments VIII LP

(Last) (First) (Middle)
3000 SAND HILL ROAD
BUILDING 1, SUITE 135

(Street)
MENLO PARK CA 94025

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
ROEDER DOUGLAS A

(Last) (First) (Middle)
3000 SAND HILL ROAD
BUILDING 1, SUITE 135

(Street)
MENLO PARK CA 94025

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
X Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
BOCHNOWSKI JAMES J

(Last) (First) (Middle)
3000 SAND HILL ROAD
BUILDING 1, SUITE 135

(Street)
MENLO PARK CA 94025

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
DOUGLASS DAVID L

(Last) (First) (Middle)
3000 SAND HILL ROAD
BUILDING 1, SUITE 135

(Street)
MENLO PARK CA 94025

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
PAKIANATHAN DEEPIKA

(Last) (First) (Middle)
3000 SAND HILL ROAD
BUILDING 1, SUITE 135

(Street)
MENLO PARK CA 94025

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
Explanation of Responses:
1. The securities are immediately convertible.
2. The expiration date is not relevant to the conversion of these securities.
3. The reported securities are owned directly by Delphi Ventures VIII, L.P. ("DV VIII"). Delphi Management Partners VIII, L.L.C. (the "General Partner"), as general partner of Delphi Ventures VIII, L.P., and Douglas A. Roeder, James J. Bochnowski, David L. Douglass and Deepika R. Pakianathan, Ph.D., the managing members of the General Partner, may be deemed to share voting and dispositive power over the reported securities but each disclaims beneficial ownership in the securities held by DV VIII, except to the extent of their pecuniary interest therein.
4. The reported securities are owned directly by Delphi BioInvestments VIII, L.P. ("DBI VIII"). The General Partner, as general partner of Delphi BioInvestments VIII, L.P., and Douglas A. Roeder, James J. Bochnowski, David L. Douglass and Deepika R. Pakianathan, Ph.D., the managing members of the General Partner, may be deemed to share voting and dispositive power over the reported securities but each disclaims beneficial ownership in the securities held by DBI VIII, except to the extent of their pecuniary interest therein.
Remarks:
/s/ David B. Berger, Attorney-in-Fact for Delphi Management Partners VIII, L.L.C. 11/13/2013
/s/ David B. Berger, Attorney-in-Fact for Delphi Ventures VIII, L.P. 11/13/2013
/s/ David B. Berger, Attorney-in-Fact for Delphi BioInvestments VIII, L.P. 11/13/2013
/s/ David B. Berger, Attorney-in-Fact for Douglas A. Roeder 11/13/2013
/s/ David B. Berger, Attorney-in-Fact for James T. Bochnowski 11/13/2013
/s/ David B. Berger, Attorney-in-Fact for David L. Douglass 11/13/2013
/s/ David B. Berger, Attorney-in-Fact for Deepika R. Pakianathan 11/13/2013
** 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.