Sec Form 3 Filing - NEALE MATTHEW @ AGILITI, INC. \DE - 2023-05-04

Insider filing report for Changes in Beneficial Ownership
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FORM 3
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
NEALE MATTHEW
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)
SVP, Chief Information Officer
(Last) (First) (Middle)
C/O AGILITI, INC., 11095 VIKING DRIVE, SUITE 300
3. Date of Earliest Transaction (MM/DD/YY)
05/04/2023
(Street)
EDEN PRAIRIE, MN55344
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 8,491 D
Common Stock, $0.0001 par value 15 I By son
Common Stock, $0.0001 par value 15 I By daughter
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) $ 21.61 ( 1 ) 07/06/2031 Common Stock, $0.0001 par value 7,520 D
Options (Right to Buy) $ 18.45 ( 2 ) 03/03/2032 Common Stock, $0.0001 par value 8,808 D
Options (Right to Buy) $ 14.83 ( 3 ) 03/10/2033 Common Stock, $0.0001 par value 11,103 D
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
NEALE MATTHEW
C/O AGILITI, INC.
11095 VIKING DRIVE, SUITE 300
EDEN PRAIRIE, MN55344
SVP, Chief Information Officer
Signatures
/s/ Lee M. Neumann, by power of attorney 05/12/2023
Signature of Reporting Person Date
Explanation of Responses:
( 1 )The reporting person received 7,520 options under the Agiliti, Inc. Amended and Restated 2018 Omnibus Incentive Plan on July 6, 2021. The options vest ratably on each of July 6, 2022, July 6, 2023 and July 6, 2024, subject to the reporting person remaining in continuous employment with the issuer on the vesting date.
( 2 )The reporting person received 8,808 options under the Agiliti, Inc. Amended and Restated 2018 Omnibus Incentive Plan on March 3, 2022. The options vest ratably on each of March 6, 2023, March 6, 2024 and March 6, 2025, subject to the reporting person remaining in continuous employment with the issuer on the vesting date.
( 3 )The reporting person received 11,103 options under the Agiliti, Inc. Amended and Restated 2018 Omnibus Incentive Plan on March 10, 2023. The options vest ratably on each of March 10, 2024, March 10, 2025 and March 10, 2026, 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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