0001438133-22-000118.txt : 20220527 0001438133-22-000118.hdr.sgml : 20220527 20220527214353 ACCESSION NUMBER: 0001438133-22-000118 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220525 FILED AS OF DATE: 20220527 DATE AS OF CHANGE: 20220527 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BLICKENSTAFF KIM D CENTRAL INDEX KEY: 0001238913 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36189 FILM NUMBER: 22980165 MAIL ADDRESS: STREET 1: C/O MEDIVATION, INC. STREET 2: 201 SPEAR STREET, 3RD FLOOR CITY: SAN FRANCISCO STATE: CA ZIP: 94105 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: TANDEM DIABETES CARE INC CENTRAL INDEX KEY: 0001438133 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 204327508 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 11075 ROSELLE STREET CITY: San Diego STATE: CA ZIP: 92121 BUSINESS PHONE: 858-366-6900 MAIL ADDRESS: STREET 1: 11075 ROSELLE STREET CITY: San Diego STATE: CA ZIP: 92121 4 1 wf-form4_165370220405871.xml FORM 4 X0306 4 2022-05-25 0 0001438133 TANDEM DIABETES CARE INC TNDM 0001238913 BLICKENSTAFF KIM D C/O TANDEM DIABETES CARE, INC. 11075 ROSELLE STREET SAN DIEGO CA 92121 1 0 0 0 Common Stock 10657 D Common Stock 205190 I See Footnote Restricted Stock Unit 2022-05-25 4 A 0 2757 0 A Common Stock 2757.0 2757 D The securities are held by the Kim Blickenstaff Revocable Trust dated April 15, 2010. Awarded on May 25, 2022 pursuant to the Tandem Diabetes Care, Inc. 2013 Stock Incentive Plan, as amended, and the agreements related thereto (the "2013 Plan"). Each restricted stock unit ("RSU") represents a contingent right to receive either one share of common stock of the Issuer or cash in lieu thereof, at the Issuer's discretion, in accordance with the terms of the 2013 Plan. RSU will vest on the one-year anniversary of the grant date, subject to the terms of the 2013 Plan. s/ Rachel Malina, Attorney-in-Fact for Kim D. Blickenstaff 2022-05-27