Sec Form 3 Filing - PERSENAIRE MAARTEN @ TELA Bio, Inc. - 2019-11-07

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
PERSENAIRE MAARTEN
2. Issuer Name and Ticker or Trading Symbol
TELA Bio, Inc. [ TELA]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner
X __ Officer (give title below) _____ Other (specify below)
Chief Medical Officer
(Last) (First) (Middle)
C/O TELA BIO, INC., 1 GREAT VALLEY PARKWAY, SUITE 24
3. Date of Earliest Transaction (MM/DD/YY)
11/07/2019
(Street)
MALVERN, PA19355
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 42,556 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
Series A Preferred Stock ( 2 ) ( 1 ) ( 1 ) Common Stock 197,511 D
Series B Preferred Stock ( 3 ) ( 1 ) ( 1 ) Common Stock 12,760 D
Warrant $ 1.16 01/18/2017 01/18/2027 Series B Preferred Stock 12,931 D
Employee Stock Option (right to buy) $ 5.93 07/31/2019 07/23/2025 Common Stock 10,592 D
Employee Stock Option (right to buy) $ 5.93 ( 4 ) 02/28/2028 Common Stock 10,241 D
Stock Option (right to buy) $ 13 ( 5 ) 11/07/2029 Common Stock 70,879 D
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
PERSENAIRE MAARTEN
C/O TELA BIO, INC.
1 GREAT VALLEY PARKWAY, SUITE 24
MALVERN, PA19355
Chief Medical Officer
Signatures
/s/ Nora Brennan as attorney-in-fact for Maarten Persenaire 11/07/2019
Signature of Reporting Person Date
Explanation of Responses:
( 1 )Shares of Series A and Series B Preferred Stock (collectively, the "Preferred Stock") have no expiration date and are convertible, at the option of the holder, into shares of Common Stock at the then-effective conversion rate for no additional consideration (subject to the payment of cash in lieu of any fractional shares in accordance with the Issuer's Third Amended and Restated Certificate of Incorporation (as amended, the "Certificate of Incorporation")). The shares of Preferred Stock will automatically convert into shares of Common Stock at the then-effective conversion rate for no additional consideration (subject to the payment in cash in lieu of any fractional shares in accordance with the Certificate of Incorporation) immediately prior to the closing of the Issuer's initial public offering.
( 2 )Shares of Series A Preferred Stock are convertible into shares of Common Stock at a 1-for-1 conversion rate.
( 3 )Shares of Series B Preferred Stock are convertible into shares of Common Stock at a 1-for-1 conversion rate.
( 4 )The option vested 25% on February 28, 2019, with the remaining 75% vesting in equal monthly installments on the last day of each of the 36 calendar months immediately following such date, subject to the Reporting Person's continuous service with the Issuer.
( 5 )The option vests 25% on November 7, 2020, with the remaining 75% vesting in equal monthly installments on the last day of each of the 36 calendar months immediately following such date, subject to the Reporting Person's continuous service with the Issuer.

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* If the form is filed by more than one reporting person, see Instruction 4(b)(v).
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