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Filing Details

Accession Number:: 0001209191-21-012519
Form Type:: 4
Zero Holdings:: No
Publication Time:: 2021-02-19 18:18:21
Reporting Period:: 2021-02-17

Accepted Time:: 2021-02-19 18:18:21
SEC Url:: Form 4 Filing

Issuer

Cik	Name	Symbol	Sector (SIC)	IRS No
1584751	Talis Biomedical Corp	TLIS	()	4

Insiders

Cik	Name	Reported Address	Insider Title	Director	Officer	Large Shareholder	Other
1337801	W. Randal Scott	C/O Talis Biomedical Corporation 230 Constitution Drive Menlo Park CA 94025		Yes	No	No	No

Reported Non-Derivative Transactions

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Sec. Name	Acquisiton - Disposition	Date	Amount	Price	Remaning Holdings	Equity Swap Involved	Form Type	Code	Nature of Ownership	Explanation
Common Stock	Acquisiton	2021-02-17	752,897	$0.00	752,897	No	4	C	Indirect	By Thinking Bench Capital, LLC
Common Stock	Acquisiton	2021-02-17	334,546	$0.00	1,087,443	No	4	C	Indirect	By Thinking Bench Capital, LLC
Common Stock	Acquisiton	2021-02-17	302,621	$0.00	1,390,064	No	4	C	Indirect	By Thinking Bench Capital, LLC
Common Stock	Acquisiton	2021-02-17	312,500	$16.00	312,500	No	4	P	Indirect	By OG Family Trust, u/d/t May 30, 2014

Equity Swap Involved	Form Type	Code	Nature of Ownership	Explanation
No	4	C	Indirect	By Thinking Bench Capital, LLC
No	4	C	Indirect	By Thinking Bench Capital, LLC
No	4	C	Indirect	By Thinking Bench Capital, LLC
No	4	P	Indirect	By OG Family Trust, u/d/t May 30, 2014

Reported Derivative Transactions

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Sec. Name	Sec. Type	Acquisiton - Disposition	Date	Amount	Price	Amount - 2	Price - 2
Common Stock	Series D-1 Preferred Stock	Disposition	2021-02-17	1,076,643	$0.00	752,897	$0.00
Common Stock	Series E-1 Preferred Stock	Disposition	2021-02-17	478,402	$0.00	334,546	$0.00
Common Stock	Series F-1 Preferred Stock	Disposition	2021-02-17	432,749	$0.00	302,621	$0.00

Equity Swap Involved	Transaction Form Type	Transaction Code	Nature of Ownership
No	4	C	Indirect
No	4	C	Indirect
No	4	C	Indirect

Footnotes

Each share of Series D-1 Preferred Stock automatically converts on a 1-for-1.43 basis into Common Stock at any time at the holder's election and has no expiration date. At the closing of the Issuer's initial public offering, each share of Series D-1 Preferred stock converted into shares of Common Stock, for no additional consideration, at a rate of one share of Common Stock for each 1.43 shares of Series D-1 Preferred Stock.
The shares are held by Thinking Bench Capital, LLC, for which Dr. Scott is the manager. The OG Family Trust, u/d/t May 30, 2014 is the sole member of Thinking Bench Capital, LLC. Dr. Scott and his spouse are trustees and share voting and dispositive power of the OG Family Trust, u/d/t May 30, 2014.
Each share of Series E-1 Preferred Stock automatically converts on a 1-for-1.43 basis into Common Stock at any time at the holder's election and has no expiration date. At the closing of the Issuer's initial public offering, each share of Series E-1 Preferred stock converted into shares of Common Stock, for no additional consideration, at a rate of one share of Common Stock for each 1.43 shares of Series E-1 Preferred Stock.
Each share of Series F-1 Preferred Stock automatically converts on a 1-for-1.43 basis into Common Stock at any time at the holder's election and has no expiration date. At the closing of the Issuer's initial public offering, each share of Series F-1 Preferred stock converted into shares of Common Stock, for no additional consideration, at a rate of one share of Common Stock for each 1.43 shares of Series F-1 Preferred Stock.
The shares are held directly by the OG Family Trust, u/d/t May 30, 2014. Dr. Scott and his spouse are trustees and share voting and dispositive power over the shares held by OG Family Trust, u/d/t May 30, 2014.