0001209191-19-061996.txt : 20191226 0001209191-19-061996.hdr.sgml : 20191226 20191226185405 ACCESSION NUMBER: 0001209191-19-061996 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20191220 FILED AS OF DATE: 20191226 DATE AS OF CHANGE: 20191226 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Chen Richard CENTRAL INDEX KEY: 0001779787 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38943 FILM NUMBER: 191311485 MAIL ADDRESS: STREET 1: C/O PERSONALIS, INC. STREET 2: 1330 O'BRIEN DRIVE CITY: MENLO PARK STATE: CA ZIP: 94025 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 2019-12-20 0 0001527753 Personalis, Inc. PSNL 0001779787 Chen Richard C/O PERSONALIS, INC. 1330 O'BRIEN DRIVE MENLO PARK CA 94025 0 1 0 0 Chief Scientific Officer Common Stock 2019-12-20 4 M 0 12000 0.44 A 47000 D Stock Option (right to buy) 0.44 2019-12-20 4 M 0 12000 0.00 D 2022-03-07 Common Stock 12000 277249 D The shares subject to the option are fully vested and exercisable. /s/ Aaron Tachibana, Attorney-in-Fact 2019-12-26