0001209191-23-045690.txt : 20230814 0001209191-23-045690.hdr.sgml : 20230814 20230814174717 ACCESSION NUMBER: 0001209191-23-045690 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230810 FILED AS OF DATE: 20230814 DATE AS OF CHANGE: 20230814 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: HICKS KERRY R CENTRAL INDEX KEY: 0001110473 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39813 FILM NUMBER: 231172369 MAIL ADDRESS: STREET 1: C/O HEALTHGRADES.COM STREET 2: 44 UNION BLVD SUITE 600 CITY: LAKEOOD STATE: CO ZIP: 80228 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: TriSalus Life Sciences, Inc. CENTRAL INDEX KEY: 0001826667 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MEDICAL LABORATORIES [8071] IRS NUMBER: 853009869 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 6272 WEST 91ST AVENUE CITY: WESTMINSTER STATE: CO ZIP: 80031 BUSINESS PHONE: 415 336 8917 MAIL ADDRESS: STREET 1: 6272 WEST 91ST AVENUE CITY: WESTMINSTER STATE: CO ZIP: 80031 FORMER COMPANY: FORMER CONFORMED NAME: MedTech Acquisition Corp DATE OF NAME CHANGE: 20200930 4 1 doc4.xml FORM 4 SUBMISSION X0508 4 2023-08-10 0 0001826667 TriSalus Life Sciences, Inc. TLSI 0001110473 HICKS KERRY R 6272 W. 91ST AVENUE WESTMINSTER CO 80031 1 0 0 0 0 Stock Option (right to buy) 11.34 2023-08-10 4 A 0 35000 0.00 A 2033-08-09 Common Stock 35000 35000 D The shares subject to this stock option vest in three equal annual installments from the vesting commencement date of August 10, 2023, subject to the Reporting Person's continued service with the Issuer on each respective vesting date. /s/ Sean Murphy, Attorney-in-Fact for Kerry Hicks 2023-08-14