0001209191-19-038863.txt : 20190624 0001209191-19-038863.hdr.sgml : 20190624 20190624200133 ACCESSION NUMBER: 0001209191-19-038863 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190624 FILED AS OF DATE: 20190624 DATE AS OF CHANGE: 20190624 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: LUDLUM KEN CENTRAL INDEX KEY: 0001255825 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38943 FILM NUMBER: 19916599 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Personalis, Inc. CENTRAL INDEX KEY: 0001527753 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MEDICAL LABORATORIES [8071] IRS NUMBER: 275411038 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1330 O'BRIEN DRIVE CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: 650-752-1300 MAIL ADDRESS: STREET 1: 1330 O'BRIEN DRIVE CITY: MENLO PARK STATE: CA ZIP: 94025 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2019-06-24 0 0001527753 Personalis, Inc. PSNL 0001255825 LUDLUM KEN C/O PERSONALIS, INC. 1330 O'BRIEN DRIVE MENLO PARK CA 94025 1 0 0 0 Common Stock 2019-06-24 4 P 0 70000 17.00 A 70000 I See footnote Common Stock 45833 D Represents shares acquired pursuant to a directed share program in connection with the Issuer's initial public offering of Common Stock. The shares are held of record by Kenneth E. Ludlum Revocable Living Trust Under Agreement Dated April 19, 2013, for which the Reporting Person serves as trustee. /s/ Peter Mandel, Attorney-in-Fact 2019-06-24