Sec Form 4 Filing - Shiblaq Hisham @ PROCEPT BioRobotics Corp - 2023-02-16

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
Shiblaq Hisham
2. Issuer Name and Ticker or Trading Symbol
PROCEPT BioRobotics Corp [ PRCT]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner
X __ Officer (give title below) _____ Other (specify below)
EVP, Chief Comm. Officer
(Last) (First) (Middle)
C/O PROCEPT BIOROBOTICS CORPORATION, 900 ISLAND DRIVE
3. Date of Earliest Transaction (MM/DD/YY)
02/16/2023
(Street)
REDWOOD CITY, CA94065
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 02/16/2023 A 26,315 ( 1 ) A $ 0 53,590 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
Stock Option (Right to Buy) $ 37.02 02/16/2023 A 47,732 ( 2 ) 02/15/2033 Common Stock 47,732 $ 0 47,732 D
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Shiblaq Hisham
C/O PROCEPT BIOROBOTICS CORPORATION
900 ISLAND DRIVE
REDWOOD CITY, CA94065
EVP, Chief Comm. Officer
Signatures
/s/ Jonathan Stone, Attorney-in-Fact for Hisham Shiblaq 02/21/2023
Signature of Reporting Person Date
Explanation of Responses:
( 1 )These securities are restricted stock units (RSUs). Each RSU represents a contingent right to receive one share of Common Stock. 1/4th of the RSUs shall vest on the anniversary of the vesting commencement date of March 5, 2023, and annually over a three year period thereafter, subject to continued employment or service by the Reporting Person to the Issuer through the applicable vesting date.
( 2 )1/48th of the shares subject to the Stock Option shall vest monthly from the vesting commencement date of March 5, 2023 over a four year period, subject continued employment or service by the Reporting Person to the Issuer through the applicable 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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