0001415889-24-017312.txt : 20240617 0001415889-24-017312.hdr.sgml : 20240617 20240617214528 ACCESSION NUMBER: 0001415889-24-017312 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240613 FILED AS OF DATE: 20240617 DATE AS OF CHANGE: 20240617 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Leonsis Theodore CENTRAL INDEX KEY: 0001452645 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-42130 FILM NUMBER: 241050052 MAIL ADDRESS: STREET 1: WASHINGTON CAPITALS STREET 2: 627 N GLEBE RD SUITE 850 CITY: ARLINGTON STATE: VA ZIP: 22203 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Tempus AI, Inc. CENTRAL INDEX KEY: 0001717115 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER PROGRAMMING, DATA PROCESSING, ETC. [7370] ORGANIZATION NAME: 06 Technology IRS NUMBER: 474903308 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 600 WEST CHICAGO AVENUE STREET 2: SUITE 510 CITY: CHICAGO STATE: IL ZIP: 60654 BUSINESS PHONE: 800-976-5448 MAIL ADDRESS: STREET 1: 600 WEST CHICAGO AVENUE STREET 2: SUITE 510 CITY: CHICAGO STATE: IL ZIP: 60654 FORMER COMPANY: FORMER CONFORMED NAME: Tempus Labs, Inc. DATE OF NAME CHANGE: 20170915 4 1 form4-06172024_090624.xml X0508 4 2024-06-13 0001717115 Tempus AI, Inc. TEM 0001452645 Leonsis Theodore C/O TEMPUS AI, INC. 600 WEST CHICAGO AVENUE, SUITE 510 CHICAGO IL 60654 true false false false 0 Class A Common Stock 2024-06-13 4 A 0 13514 0 A 13514 D Class A Common Stock 2024-06-17 4 C 0 3263060 A 3263060 I By Revolution Growth III, LP Class A Common Stock 2024-06-17 4 A 0 397888 A 3660948 I By Revolution Growth III, LP Series C Preferred Stock 2024-06-17 4 C 0 1397057 0 D Class A Common Stock 1397057 0 I By Revolution Growth III, LP Series D Preferred Stock 2024-06-17 4 C 0 1066791 0 D Class A Common Stock 1066791 0 I By Revolution Growth III, LP Series E Preferred Stock 2024-06-17 4 C 0 597271 0 D Class A Common Stock 597271 0 I Revolution Growth III, LP Series F Preferred Stock 2024-06-17 4 C 0 201941 0 D Class A Common Stock 201941 0 I By Revolution Growth III, LP Represents a restricted stock unit ("RSU") award. The RSUs vest in 20 substantially equal quarterly installments commencing on September 13, 2024. Each share of Series C Preferred Stock, Series D Preferred Stock, Series E Preferred Stock and Series F Preferred Stock was convertible at any time, at the holder's election, into Class A Common Stock, on a one-for-one basis, had no expiration date and automatically converted into shares of Class A Common Stock upon the closing of the Issuer's initial public offering. The Reporting Person is a member of the investment committee of the ultimate general partner of Revolution Growth III, LP ("RG III") and may be deemed to share dispositive power over the shares held by RG III. On June 17, 2024, in connection with the conversion of preferred stock upon the closing of the Issuer's initial public offering, Issuer paid accrued and unpaid dividends on such shares of preferred stock in shares of Class A Common Stock. The issuance of shares qualifies for the exemption from Section 16 of the Securities Exchange Act pursuant to Rules 16b-3 and 16a-9. /s/ Erik Phelps, Attorney-in-Fact 2024-06-17