Sec Form 4 Filing - MCCABE MATTHEW E. @ AGILITI, INC. \DE - 2021-04-27

Insider filing report for Changes in Beneficial Ownership
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FORM 4
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
MCCABE MATTHEW E.
2. Issuer Name and Ticker or Trading Symbol
AGILITI, INC. \DE [ AGTI]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner
X __ Officer (give title below) _____ Other (specify below)
VP of Finance & Treasurer
(Last) (First) (Middle)
C/O AGILITI, INC., 6625 WEST 78TH STREET, SUITE 300
3. Date of Earliest Transaction (MM/DD/YY)
04/27/2021
(Street)
MINNEAPOLIS, MN55439
4. If Amendment, Date Original Filed (MM/DD/YY)
6. Individual or Joint/Group Filing (Check Applicable Line)
__ X __ Form filed by One Reporting Person
_____ Form filed by More than One Reporting Person
(City) (State) (Zip)
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Transaction Date (MM/DD/YY) 2A. Deemed Execution Date, if any (MM/DD/YY) 3. Transaction Code
(Instr. 8)
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4)
7. Nature of Indirect Beneficial Ownership
(Instr. 4)
Code V Amount (A) or (D) Price
Common Stock, $0.0001 par value 04/27/2021 P( 1 ) 750 A $ 14 30,408 D
Common Stock, $0.0001 par value ( 2 ) 04/27/2021 A 3,214 A $ 0 33,622 D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
( e.g. , puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (MM/DD/YY) 3A. Deemed Execution Date, if any (MM/DD/YY) 4. Transaction Code
(Instr. 8)
5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4, and 5)
6. Date Exercisable and Expiration Date
(MM/DD/YY)
7. Title and Amount of Underlying Securities
(Instr. 3 and 4)
8. Price of Derivative Security
(Instr. 5)
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 4)
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 4)
11. Nature of Indirect Beneficial Ownership
(Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Options (Right to Buy) $ 14 04/27/2021 A 9,643 ( 3 ) 04/27/2031 Common Stock, $0.0001 par value 9,643 $ 0 9,643 D
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
MCCABE MATTHEW E.
C/O AGILITI, INC.
6625 WEST 78TH STREET, SUITE 300
MINNEAPOLIS, MN55439
VP of Finance & Treasurer
Signatures
/s/ Lee M. Neumann, by power of attorney 04/29/2021
Signature of Reporting Person Date
Explanation of Responses:
( 1 )The purchase reported in this Form 4 was effected pursuant to a directed share program held by the issuer in connection with its initial public offering.
( 2 )In connection with the issuer's initial public offering, the reporting person received 3,214 restricted share units ("RSUs") under the Agiliti, Inc. Amended and Restated 2018 Omnibus Incentive Plan. The RSUs vest ratably on each of March 6, 2022, March 6, 2023 and March 6, 2024, subject to the reporting person remaining in continuous employment with the issuer on the vesting date.
( 3 )In connection with the issuer's initial public offering, the reporting person received 9,643 options under the Agiliti, Inc. Amended and Restated 2018 Omnibus Incentive Plan. The options vest ratably on each of March 6, 2022, March 6, 2023 and March 6, 2024, subject to the reporting person remaining in continuous employment with the issuer on the vesting date.

Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4(b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).

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