4//SEC Filing
KEYWELL BRADLEY A 4
Accession 0001493152-24-025322
CIK 0001717115other
Filed
Jun 25, 8:00 PM ET
Accepted
Jun 26, 7:17 PM ET
Size
19.9 KB
Accession
0001493152-24-025322
Insider Transaction Report
Form 4
KEYWELL BRADLEY A
10% Owner
Transactions
- Conversion
Series B-1 Preferred Stock
2024-06-17−499,964→ 0 total(indirect: By LLC)→ Class A Common Stock (499,964 underlying) - Conversion
Series D Preferred Stock
2024-06-17−63,653→ 0 total(indirect: By LLC)→ Class A Common Stock (63,653 underlying) - Conversion
Series G Preferred Stock
2024-06-17−15,558→ 0 total(indirect: By LLC)→ Class A Common Stock (15,558 underlying) - Conversion
Class A Common Stock
2024-06-17+2,169,419→ 16,560,249 total(indirect: By LLC) - Conversion
Series A Preferred Stock
2024-06-17−1,109,189→ 0 total(indirect: By LLC)→ Class A Common Stock (1,109,189 underlying) - Conversion
Series C Preferred Stock
2024-06-17−314,338→ 0 total(indirect: By LLC)→ Class A Common Stock (314,338 underlying) - Conversion
Series B-2 Preferred Stock
2024-06-17−166,717→ 0 total(indirect: By LLC)→ Class A Common Stock (166,717 underlying)
Footnotes (3)
- [F1]Each share of Series A Preferred Stock, Series B-1 Preferred Stock, Series B-2 Preferred Stock, Series C Preferred Stock, Series D Preferred Stock and Series G Preferred Stock (collectively, the "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.
- [F2]This amount includes an additional 15,830 shares acquired by the Reporting Person on June 17, 2024 in connection with the conversion of the Preferred Stock into Class A Common Stock upon the closing of the Issuer's initial public offering, pursuant to which the Issuer paid accrued and unpaid dividends on such shares of Preferred Stock in shares of Class A Common Stock. This amount was also reflected in the Reporting Person's Form 3 filing on June 20, 2024. The issuance of such shares of Class A Common Stock qualifies for the exemption from Section 16 of the Securities Exchange Act pursuant to Rule 16a-9.
- [F3]The Reporting Person is the sole manager and the sole member of BK TL21 LLC.
Documents
Issuer
Tempus AI, Inc.
CIK 0001717115
Entity typeother
IncorporatedDE
Related Parties
1- filerCIK 0001114238
Filing Metadata
- Form type
- 4
- Filed
- Jun 25, 8:00 PM ET
- Accepted
- Jun 26, 7:17 PM ET
- Size
- 19.9 KB