0001493152-24-033271.txt : 20240820 0001493152-24-033271.hdr.sgml : 20240820 20240820161755 ACCESSION NUMBER: 0001493152-24-033271 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240816 FILED AS OF DATE: 20240820 DATE AS OF CHANGE: 20240820 REPORTING-OWNER: OWNER 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 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38943 FILM NUMBER: 241225349 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 NAME: FORMER CONFORMED NAME: Tempus Labs, Inc. DATE OF NAME CHANGE: 20170915 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Personalis, Inc. CENTRAL INDEX KEY: 0001527753 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MEDICAL LABORATORIES [8071] ORGANIZATION NAME: 08 Industrial Applications and Services IRS NUMBER: 275411038 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 6600 DUMBARTON CIRCLE CITY: FREMONT STATE: CA ZIP: 94555 BUSINESS PHONE: 650-752-1300 MAIL ADDRESS: STREET 1: 6600 DUMBARTON CIRCLE CITY: FREMONT STATE: CA ZIP: 94555 4 1 ownership.xml X0508 4 2024-08-16 0 0001527753 Personalis, Inc. PSNL 0001717115 Tempus AI, Inc. 600 WEST CHICAGO AVENUE SUITE 510 CHICAGO, IL 60654 0 0 1 0 0 Common Stock 2024-08-16 4 X 0 4609400 1.50 A 4609400 D Common Stock 2024-08-16 4 X 0 4609400 2.50 A 9218800 D Common Stock 2024-08-16 4 P 0 3500000 5.07 A 12718800 D Warrant (Right to Buy) 1.50 2024-08-16 4 X 0 4609400 D 2023-11-28 2024-12-31 Common Stock 4609400 0 D Warrant (Right to Buy) 2.50 2024-08-16 4 X 0 4609400 D 2023-11-28 2025-12-31 Common Stock 4609400 0 D The Reporting Person acquired the warrants as partial consideration for its obligations to the Issuer under that certain Commercialization and Reference Laboratory Agreement, dated November 25, 2023, between the Issuer and the Reporting Person. Tempus AI, Inc. By: /s/ Andrew Polovin, General Counsel 2024-08-20