0001209191-21-068753.txt : 20211209 0001209191-21-068753.hdr.sgml : 20211209 20211209161457 ACCESSION NUMBER: 0001209191-21-068753 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211208 FILED AS OF DATE: 20211209 DATE AS OF CHANGE: 20211209 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Kelley Robert J. CENTRAL INDEX KEY: 0001845542 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40047 FILM NUMBER: 211482116 MAIL ADDRESS: STREET 1: 230 CONSTITUTION DRIVE CITY: MENLO PARK STATE: CA ZIP: 94025 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Talis Biomedical Corp CENTRAL INDEX KEY: 0001584751 STANDARD INDUSTRIAL CLASSIFICATION: LABORATORY ANALYTICAL INSTRUMENTS [3826] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 230 CONSTITUTION DRIVE CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: 650-433-3000 MAIL ADDRESS: STREET 1: 230 CONSTITUTION DRIVE CITY: MENLO PARK STATE: CA ZIP: 94025 FORMER COMPANY: FORMER CONFORMED NAME: SlipChip Corp DATE OF NAME CHANGE: 20130820 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2021-12-08 0 0001584751 Talis Biomedical Corp TLIS 0001845542 Kelley Robert J. C/O TALIS BIOMEDICAL CORPORATION 230 CONSTITUTION DRIVE MENLO PARK CA 94025 1 1 0 0 Chief Executive Officer Stock Option (right to buy) 4.28 2021-12-08 4 A 0 450000 0.00 A 2031-12-07 Common Stock 450000 450000 D 25% of the shares underlying this option shall vest on the first annual anniversary of the vesting commencement date and 1/48th of the shares underlying this option shall vest monthly thereafter over 36 months. /s/ J. Roger Moody, Jr., Attorney-in-Fact for Robert J. Kelley 2021-12-09