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