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