Sec Form 4 Filing - Nelson Todd Robert @ Telesis Bio Inc. - 2023-06-22

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
Nelson Todd Robert
2. Issuer Name and Ticker or Trading Symbol
Telesis Bio Inc. [ TBIO]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X __ Director X __ 10% Owner
X __ Officer (give title below) _____ Other (specify below)
Chief Executive Officer
(Last) (First) (Middle)
C/O TELESIS BIO INC., 10431 WATERIDGE CIRCLE, SUITE 150
3. Date of Earliest Transaction (MM/DD/YY)
06/22/2023
(Street)
SAN DIEGO, CA92121
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 06/22/2023 A 47,700 ( 1 ) A $ 0 178,996 D
Common Stock 03/01/2024 F( 2 ) 4,756 D $ 0.528 174,240 D
Common Stock 6,000,000 I See footnote ( 3 )
Common Stock 122,516 I See footnote ( 4 )
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) $ 1.66 06/22/2023 A 385,500 ( 5 ) 06/22/2032 Common Stock 385,500 $ 0 385,500 D
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Nelson Todd Robert
C/O TELESIS BIO INC.
10431 WATERIDGE CIRCLE, SUITE 150
SAN DIEGO, CA92121
X X Chief Executive Officer
Signatures
/s/ Rob Cutler, as Attorney-in-Fact 03/05/2024
Signature of Reporting Person Date
Explanation of Responses:
( 1 )The Reporting Person was granted restricted stock units ("RSUs"), which represent a contingent right to receive one share of Issuer's Common Stock for each RSU. Subject to the Reporting Person's continuing as a Service Provider (as defined in the Issuer's 2021 Stock Incentive Plan (the "Plan")) through each applicable vesting date, 25% of the RSUs shall vest on each of March 1, 2024, March 1, 2025, March 1, 2026, and March 1, 2027.
( 2 )Represents the number of shares withheld by the Issuer to satisfy the tax withholding obligation in connection with the vesting of RSUs.
( 3 )Shares held of record by GATTACA Mining LLC ("GATTACA"). The Reporting Person is the managing member of GATTACA and may be deemed to have voting and dispositive power over the shares held by GATTACA.
( 4 )Shares held of record by M-185 Corporation ("M-185"). The Reporting Person is the majority owner of M-185 and may be deemed to have voting and dispositive power over the shares held by M-185.
( 5 )Subject to the Reporting Person's continuing as a Service Provider (as defined in the Plan) through each applicable vesting date, twenty-five percent (25%) of the shares subject to the option shall vest on March 1, 2024, and one thirty-sixth (1/36th) of the remaining shares subject to the option shall vest each month thereafter.

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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