0001209191-23-045710.txt : 20230814 0001209191-23-045710.hdr.sgml : 20230814 20230814190255 ACCESSION NUMBER: 0001209191-23-045710 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20230810 FILED AS OF DATE: 20230814 DATE AS OF CHANGE: 20230814 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Alecxih James CENTRAL INDEX KEY: 0001725232 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39813 FILM NUMBER: 231172670 MAIL ADDRESS: STREET 1: C/O NEVRO CORP. STREET 2: 1800 BRIDGE PARKWAY CITY: REDWOOD CITY STATE: CA ZIP: 94065 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: TriSalus Life Sciences, Inc. CENTRAL INDEX KEY: 0001826667 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MEDICAL LABORATORIES [8071] IRS NUMBER: 853009869 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 6272 WEST 91ST AVENUE CITY: WESTMINSTER STATE: CO ZIP: 80031 BUSINESS PHONE: 415 336 8917 MAIL ADDRESS: STREET 1: 6272 WEST 91ST AVENUE CITY: WESTMINSTER STATE: CO ZIP: 80031 FORMER COMPANY: FORMER CONFORMED NAME: MedTech Acquisition Corp DATE OF NAME CHANGE: 20200930 3 1 doc3.xml FORM 3 SUBMISSION X0206 3 2023-08-10 0 0001826667 TriSalus Life Sciences, Inc. TLSI 0001725232 Alecxih James 6272 W. 91ST AVENUE WESTMINSTER CO 80031 0 1 0 0 President, Device Technology Common Stock 94754 D Employee Stock Option (right to buy) 10.30 2033-05-18 Common Stock 94754 D The securities reported herein were acquired by the Reporting Person prior to the Reporting Person becoming an executive officer of the Issuer. The Reporting Person was appointed as an executive officer of the Issuer effective immediately after the effective time of the Merger (as defined in that certain Agreement and Plan of Merger, dated as of November 11, 2022, as amended, by and among the Issuer, MTAC Merger Sub, Inc., and TriSalus Operating Life Sciences, Inc.). Represents grant of restricted stock units (the "RSU Award") payable solely in common stock of the Issuer. The shares subject to the RSU Award vest in four equal annual installments commencing on February 20, 2024, subject to the Reporting Person's continued service with the Issuer on each respective vesting date. Twenty-five percent of the shares subject to the option vest on February 20, 2024, the first anniversary of the vesting commencement date, and the remainder vests in 36 equal monthly installments thereafter, subject to the Reporting Person's continued service with the Issuer on each respective vesting date. /s/ Sean Murphy, Attorney-in-Fact for James Alecxih 2023-08-14 EX-24 2 poa.txt POA DOCUMENT POWER OF ATTORNEY Know all by these presents, that the undersigned hereby constitutes and appoints each of Mary Szela and Sean Murphy of TriSalus Life Sciences, Inc. (the "Company") and Alla Kagan of Cooley LLP, signing individually, as the undersigned's true and lawful attorneys-in fact and agents to: (1) execute for and on behalf of the undersigned, in the undersigned's capacity as an officer, director and/or greater than 10% stockholder of the Company, Forms 3, 4 and 5 (including any amendments thereto) in accordance with Section 16(a) of the Securities Exchange Act of 1934 and the rules thereunder; (2) do and perform any and all acts for and on behalf of the undersigned which may be necessary or desirable to complete and execute any such Forms 3, 4 or 5 (including any amendments thereto) and timely file such forms with the U.S. Securities and Exchange Commission and any stock exchange or similar authority; and (3) take any other action of any nature whatsoever in connection with the foregoing which, in the opinion of such attorney-in-fact, may be of benefit to, in the best interest of, or legally required by, the undersigned, it being understood that the documents executed by such attorney-in-fact on behalf of the undersigned pursuant to this Power of Attorney shall be in such form and shall contain such terms and conditions as such attorney-in-fact may approve in such attorney-in-fact's discretion. The undersigned hereby grants to each such attorney-in-fact full power and authority to do and perform any and every act and thing whatsoever requisite, necessary or proper to be done in the exercise of any of the rights and powers herein granted, as fully to all intents and purposes as the undersigned might or could do if personally present, with full power of substitution or revocation, hereby ratifying and confirming all that such attorney-in-fact, or such attorney-in-fact's substitute or substitutes, shall lawfully do or cause to be done by virtue of this power of attorney and the rights and powers herein granted. The undersigned acknowledges that the foregoing attorneys-in-fact, in serving in such capacity at the request of the undersigned, are not assuming, nor is the Company assuming, any of the undersigned's responsibilities to comply with Section 16 of the Securities Exchange Act of 1934, as amended. This Power of Attorney shall remain in full force and effect until the earliest to occur of (a) the undersigned is no longer required to file Forms 3, 4 and 5 with respect to the undersigned's holdings of and transactions in securities issued by the Company, (b) revocation by the undersigned in a signed writing delivered to the foregoing attorneys-in-fact or (c) as to any attorney-in-fact individually, until such attorney-in-fact is no longer employed by the Company or employed by or a partner at Cooley LLP, as applicable. The undersigned has caused this Power of Attorney to be executed as of July 20, 2023. James Alecxih /s/ James Alecxih (Signature)