0001415889-24-016757.txt : 20240613
0001415889-24-016757.hdr.sgml : 20240613
20240613184216
ACCESSION NUMBER: 0001415889-24-016757
CONFORMED SUBMISSION TYPE: 3
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20240613
FILED AS OF DATE: 20240613
DATE AS OF CHANGE: 20240613
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Leonsis Theodore
CENTRAL INDEX KEY: 0001452645
ORGANIZATION NAME:
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-42130
FILM NUMBER: 241042572
MAIL ADDRESS:
STREET 1: WASHINGTON CAPITALS
STREET 2: 627 N GLEBE RD SUITE 850
CITY: ARLINGTON
STATE: VA
ZIP: 22203
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Tempus AI, Inc.
CENTRAL INDEX KEY: 0001717115
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER PROGRAMMING, DATA PROCESSING, ETC. [7370]
ORGANIZATION NAME: 06 Technology
IRS NUMBER: 474903308
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 600 WEST CHICAGO AVENUE
STREET 2: SUITE 510
CITY: CHICAGO
STATE: IL
ZIP: 60654
BUSINESS PHONE: 800-976-5448
MAIL ADDRESS:
STREET 1: 600 WEST CHICAGO AVENUE
STREET 2: SUITE 510
CITY: CHICAGO
STATE: IL
ZIP: 60654
FORMER COMPANY:
FORMER CONFORMED NAME: Tempus Labs, Inc.
DATE OF NAME CHANGE: 20170915
3
1
form3-06132024_100612.xml
X0206
3
2024-06-13
0
0001717115
Tempus AI, Inc.
TEM
0001452645
Leonsis Theodore
C/O TEMPUS AI, INC.
600 WEST CHICAGO AVENUE, SUITE 510
CHICAGO
IL
60654
true
false
false
false
Series C Preferred Stock
Class A Common Stock
1397057
I
By Revolution Growth III, LP
Series D Preferred Stock
Class A Common Stock
1066791
I
By Revolution Growth III, LP
Series E Preferred Stock
Class A Common Stock
597271
I
By Revolution Growth III, LP
Series F Preferred Stock
Class A Common Stock
201941
I
By Revolution Growth III, LP
Stock Option (right to buy)
0.8542
2028-03-12
Class A Common Stock
210000
I
By Revolution Growth Management Company, Inc.
Each share of Series C Preferred Stock, Series D Preferred Stock, Series E Preferred Stock and Series F Preferred Stock is convertible at any time, at the holder's election, into Class A Common Stock, on a one-for-one basis, has no expiration date and will automatically convert into shares of Class A Common Stock upon the closing of the Issuer's initial public offering.
The Reporting Person is a member of the investment committee of the ultimate general partner of Revolution Growth III, LP ("RG III") and a member of the board of directors of Revolution Growth Management Company, Inc. ("RGMC") and may be deemed to share dispositive power over the shares held by RG III and RGMC.
Fully vested and exercisable.
/s/ Erik Phelps, Attorney-in-Fact
2024-06-13