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