0001104659-21-128113.txt : 20211020 0001104659-21-128113.hdr.sgml : 20211020 20211020170050 ACCESSION NUMBER: 0001104659-21-128113 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211015 FILED AS OF DATE: 20211020 DATE AS OF CHANGE: 20211020 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ROEDER DOUGLAS A CENTRAL INDEX KEY: 0001270735 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36189 FILM NUMBER: 211334782 MAIL ADDRESS: STREET 1: 160 BOVET RD, SUITE 408 STREET 2: C/O DELPHI VENTURES CITY: SAN MATEO STATE: CA ZIP: 94402 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: TANDEM DIABETES CARE INC CENTRAL INDEX KEY: 0001438133 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 204327508 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 11075 ROSELLE STREET CITY: San Diego STATE: CA ZIP: 92121 BUSINESS PHONE: 858-366-6900 MAIL ADDRESS: STREET 1: 11075 ROSELLE STREET CITY: San Diego STATE: CA ZIP: 92121 4 1 tm2130602d1_4.xml FORM 4 X0306 4 2021-10-15 0 0001438133 TANDEM DIABETES CARE INC TNDM 0001270735 ROEDER DOUGLAS A C/O DELPHI VENTURES, 63 BOVET ROAD, SUITE 351 SAN MATEO CA 94402 1 0 0 0 Common Stock 2021-10-15 5 J 0 E 1000000 0 D 0 I See footnote Common Stock 2021-10-15 5 J 0 E 11568 0 A 13460 I See footnote Common Stock 2021-10-15 5 J 0 E 11568 0 D 1892 I See footnote Common Stock 2021-10-15 5 J 0 E 3766 0 A 3766 I See Footnote Represents a pro rata distribution, not for additional consideration, by Delphi BioInvestments VIII, L.P. ("DB VIII") and Delphi Ventures VIII, L.P. ("DV VIII") to their respective partners, and by Delphi Management Partners VIII, L.L.C. ("DMP"), the general partner of each of DB VIII and DV VIII, to its members and assignees, as applicable. This distribution was made pursuant to a Rule 10b5-1 distribution plan. Shares are held directly by DB VIIII and DV VIII. The Reporting Person is a managing member of DMP. As a managing member of DMP, the Reporting Person shares voting and investment power over the securities held by DB VIII and DV VIII, and may be deemed to have indirect beneficial ownership of such shares. The Reporting Person disclaims beneficial ownership of such securities, except to the extent of his proportionate pecuniary interest therein. Shares are held directly by DMP. The Reporting Person is a managing member of DMP. As a managing member of DMP, the Reporting Person shares voting and investment power over the securities held by DMP, and may be deemed to have indirect beneficial ownership of such shares. The Reporting Person disclaims beneficial ownership of such securities, except to the extent of his proportionate pecuniary interest therein. The shares are held directly by The Roeder Family Trust dated 5/29/08, of which the Reporting Person is trustee. This transaction is being voluntarily reported, reflects a change in form of beneficial ownership of the Reporting Person and is exempt from Section 16 pursuant to Rule 16a-13 under the Securities Exchange Act of 1934. /s/ Matthew T. Potter, by power of attorney for Douglas A. Roeder 2021-10-20