1. Title of Derivative Security (Instr. 4) |
2. Date Exercisable and Expiration Date (Month/Day/Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) |
4. Conversion or Exercise Price of Derivative Security |
5. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 5) |
6. Nature of Indirect Beneficial Ownership (Instr. 5) |
Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
Series B Preferred Stock
|
Â
(1)
|
Â
(2)
|
Common Stock
|
6,208
|
$
0
|
I
|
See footnote
(3)
|
Series C Preferred Stock
|
Â
(1)
|
Â
(2)
|
Common Stock
|
4,724
|
$
0
|
I
|
See footnote
(3)
|
Series C Preferred Stock
|
Â
(1)
|
Â
(2)
|
Common Stock
|
7,086
|
$
0
|
I
|
See footnote
(4)
|
Series D Preferred Stock
|
Â
(1)
|
Â
(2)
|
Common Stock
|
14,566
|
$
0
|
I
|
See footnote
(3)
|
Series D Preferred Stock
|
Â
(1)
|
Â
(2)
|
Common Stock
|
10,486
|
$
0
|
I
|
See footnote
(4)
|
Preferred Stock Warrant
|
Â
(5)
|
08/31/2021 |
Series D Preferred Stock
(6)
|
3,181
(6)
|
$
4.4
(6)
|
I
|
See footnote
(3)
|
Preferred Stock Warrant
|
Â
(5)
|
08/31/2021 |
Series D Preferred Stock
(7)
|
2,272
(7)
|
$
4.4
(7)
|
I
|
See footnote
(4)
|
Preferred Stock Warrant
|
Â
(5)
|
07/03/2022 |
Series D Preferred Stock
(8)
|
3,181
(8)
|
$
4.4
(8)
|
I
|
See footnote
(3)
|
Preferred Stock Warrant
|
Â
(5)
|
07/03/2022 |
Series D Preferred Stock
(9)
|
2,272
(9)
|
$
4.4
(9)
|
I
|
See footnote
(4)
|
Preferred Stock Warrant
|
Â
(5)
|
08/21/2022 |
Series D Preferred Stock
(10)
|
830
(10)
|
$
4.4
(10)
|
I
|
See footnote
(3)
|
Stock Option
(11)
|
Â
(12)
|
Â
(13)
|
Common Stock
|
20,888
|
$
6.77
|
D
|
Â
|
* |
If the form is filed by more than one reporting person, see Instruction 5(b)(v). |
** |
Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
(1) |
The securities are immediately convertible. |
(2) |
The expiration date is not relevant to the conversion of these securities. |
(3) |
The securities are held by the Chris J. Twomey and Rebecca J. Twomey Family Trust UTD September 20, 2002. |
(4) |
The securities are directly owed by Twomey Family Investments, LLC. The Reporting Person is co-manager of Twomey Family Investments, LLC and shares voting and investment power over the securities held by Twomey Family Investments, LLC and may be deemed to have indirect beneficial ownership of such shares. The Reporting Person disclaims beneficial ownership of such securities held by Twomey Family Investments, LLC, except to the extent of his proportionate pecuniary interest therein. |
(5) |
The warrants are immediately exercisable. |
(6) |
Upon the consummation of the Issuer's initial public offering, these warrants will automatically become exercisable for 1,898 shares of the Issuer's common stock at an exercise price of $7.37 per share. |
(7) |
Upon the consummation of the Issuer's initial public offering, these warrants will automatically become exercisable for 1,355 shares of the Issuer's common stock at an exercise price of $7.37 per share. |
(8) |
Upon the consummation of the Issuer's initial public offering, these warrants will automatically become exercisable for 1,898 shares of the Issuer's common stock at an exercise price of $7.37 per share. |
(9) |
Upon the consummation of the Issuer's initial public offering, these warrants will automatically become exercisable for 1,355 shares of the Issuer's common stock at an exercise price of $7.37 per share. |
(10) |
Upon the consummation of the Issuer's initial public offering, these warrants will automatically become exercisable for 495 shares of the Issuer's common stock at an exercise price of $7.37 per share. |
(11) |
Granted pursuant to the Issuer's Tandem Diabetes Care, Inc. 2006 Stock Incentive Plan. |
(12) |
The date of grant of the option was 8/6/2013. All shares subject to the option will vest as to 25% on 8/6/2014 and in 36 equal monthly installments thereafter. |
(13) |
The expiration date for these options is 10 years from the date of grant. |