0001209191-21-067642.txt : 20211202 0001209191-21-067642.hdr.sgml : 20211202 20211202170439 ACCESSION NUMBER: 0001209191-21-067642 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211201 FILED AS OF DATE: 20211202 DATE AS OF CHANGE: 20211202 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Blaser Brian J CENTRAL INDEX KEY: 0001492289 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40047 FILM NUMBER: 211467599 MAIL ADDRESS: STREET 1: 561 CIRCLE LANE CITY: LAKE FOREST STATE: IL ZIP: 60045 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Talis Biomedical Corp CENTRAL INDEX KEY: 0001584751 STANDARD INDUSTRIAL CLASSIFICATION: LABORATORY ANALYTICAL INSTRUMENTS [3826] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 230 CONSTITUTION DRIVE CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: 650-433-3000 MAIL ADDRESS: STREET 1: 230 CONSTITUTION DRIVE CITY: MENLO PARK STATE: CA ZIP: 94025 FORMER COMPANY: FORMER CONFORMED NAME: SlipChip Corp DATE OF NAME CHANGE: 20130820 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2021-12-01 0 0001584751 Talis Biomedical Corp TLIS 0001492289 Blaser Brian J C/O TALIS BIOMEDICAL CORPORATION 230 CONSTITUTION DRIVE MENLO PARK CA 94025 1 1 0 0 President and CEO Stock Option (right to buy) 4.47 2021-12-01 2021-12-01 4 A 0 750000 0.00 A 2031-11-30 Common Stock 750000 750000 D Restricted Stock Units 2021-12-01 2021-12-01 4 A 0 625000 0.00 A Common Stock 625000 625000 D 20% of the shares underlying this option shall vest on the first annual anniversary of the vesting commencement date and 1/60th of the shares underlying this option shall vest monthly thereafter over 48 months. Each restricted stock unit represents a contingent right to receive one share of the Company's common stock upon vesting. 20% of the shares shall vest on the first annual anniversary of the vesting commencement date and the balance of the shares will vest in a series of four equal successive annual installments. /s/ J. Roger Moody, Jr., Attorney-in-Fact for Brian Blaser 2021-12-02