0001415889-24-017302.txt : 20240617 0001415889-24-017302.hdr.sgml : 20240617 20240617214507 ACCESSION NUMBER: 0001415889-24-017302 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240613 FILED AS OF DATE: 20240617 DATE AS OF CHANGE: 20240617 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Polovin Andrew CENTRAL INDEX KEY: 0002024169 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-42130 FILM NUMBER: 241050041 MAIL ADDRESS: STREET 1: C/O TEMPUS AI, INC. STREET 2: 600 WEST CHICAGO AVENUE, SUITE 510 CITY: CHICAGO STATE: IL ZIP: 60654 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 4 1 form4-06172024_090604.xml X0508 4 2024-06-13 0001717115 Tempus AI, Inc. TEM 0002024169 Polovin Andrew C/O TEMPUS AI, INC. 600 WEST CHICAGO AVENUE, SUITE 510 CHICAGO IL 60654 false true false false EVP and General Counsel 0 Class A Common Stock 2024-06-13 4 A 0 370000 0 A 370000 D Class A Common Stock 2024-06-14 4 F 0 102411 37 D 267589 D Consists of previously granted restricted stock units ("RSUs") for which the liquidity event-based condition was satisfied upon the effectiveness of the registration statement on Form S-1 filed by the Issuer in connection with the Issuer's initial public offering. Certain of the RSUs remain subject to service-based vesting conditions, as follows: (i) 9,374 RSUs vest in three equal quarterly installments commencing on August 1, 2024; (ii) 281 RSUs vest in three substantially equal quarterly installments commencing on August 1, 2024; (iii) 40,425 RSUs vest in 11 equal quarterly installments commencing on August 15, 2024; (iv) 20,000 RSUs vest in 16 equal quarterly installments commencing on June 15, 2024; (v) 3,750 RSUs vest in three equal quarterly installments commencing on June 30, 2024; (vi) 20,000 RSUs vest in four equal quarterly installments commencing on March 31, 2025; (continued to footnote (2)). (vii) 25,000 RSUs vest in four equal quarterly installments commencing on March 31, 2026; and (viii) 20,000 RSUs vest one-third on March 15, 2025 with the remainder vesting in eight substantially equal quarterly installments commencing on June 15, 2025. Represents shares withheld to satisfy withholding tax obligations upon the vesting of restricted stock units. /s/ Erik Phelps, Attorney-in-Fact 2024-06-17