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| FORM 4 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, DC 20549 DECLARATION OF CHANGES TO CHEAP OWNERSHIP Filed under Section 16 (a) of the Securities Exchange Act of 1934 |
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Check this box if it is no longer subject to Section 16. The obligations from Form 4 or Form 5 can continue. See instruction 1 (b). |
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1. Name and address of the reporting person *
(Road) |
2. Name of the issuer and ticker or trading symbol TANDEM DIABETES CARE INC [ TNDM ] |
5. Relationship between the reporting person (s) and the issuer (Tick the appropriate)
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3. Earliest transaction date (month / day / year) 05/18/2021 |
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| 4. If change, date of original submission (month / day / year) |
6. Individual or joint / group registration (check the relevant line)
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| Table I – Non-Derivative Securities Purchased, Sold, or Economically-owned | ||||||||||
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| 1. Title of Security (Instr. 3) | 2. Transaction date (month / day / year) | 2A. If applicable, viewed as the execution date (month / day / year) | 3. Transaction code (Instr. 8) | 4. Acquired (A) or sold securities (D) (instr. 3, 4 and 5) | 5. Number of securities that are economically owned after reported transactions (instr. 3 and 4) | 6. Ownership form: Direct (D) or Indirect (I) (Instr. 4) | 7. Type of indirect beneficial ownership (Instr. 4) | |||
| code | V. | quantity | (A) or (D) | price | ||||||
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Table II – Derivative Securities Purchased, Sold, or Economically owned |
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| 1. Title of derivative security (Instr. 3) | 2. The conversion or exercise price of the derivative security | 3. Transaction date (month / day / year) | 3A. If applicable, viewed as the execution date (month / day / year) | 4. Transaction code (Instr. 8) | 5. Number of derivative securities acquired (A) or sold (D) (instr. 3, 4 and 5) | 6. Exercise date and expiry date (month / day / year) | 7. Title and amount of the securities underlying the derivative collateral (instr. 3 and 4) | 8. Price of derivative security (Instr. 5) | 9. Number of derivative securities that are economically owned after reported transactions (Instr. 4) | 10. Ownership form: Direct (D) or Indirect (I) (Instr. 4) | 11. Type of indirect beneficial ownership (Instr. 4) | ||||
| code | V. | (A) | (D) | Exercise date | Best before date | title | Number or number of shares | ||||||||
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Restricted stock unit
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05/18/2021 | A |
2.205 |
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Common stock |
2,205.00 |
$ 0
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2.205 |
D. |
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| Explanation of the answers: |
| s / David B. Berger, lawyer with Dick P. Allen | 05/20/2021 | |
| ** Signature of the reporting person | date | |
| Reminder: Report on a separate line for each class of security that is directly or indirectly economically owned. | ||
| * If the form is being submitted by more than one reporter, see instruction 4 (b) (v). | ||
| ** Deliberate misrepresentation or omission of facts constitutes federal crime violations. See 18 USC 1001 and 15 USC 78ff (a). | ||
| Note: Please make three copies of this form, one of which must be manually signed. If there is not enough space, see instruction 6. | ||
| Individuals replying to the collection of information contained in this form are only required to reply if a currently valid OMB number is displayed on the form. | ||
LAWYER The undersigned hereby composes and appoints David B. Berger, Leigh A. Vosseller, Karrie Rexford, Christina X. Sun, James W. Sytsma, and Ryan Wilkins, or any of them, to individually sign the undersigned’s true and lawful attorney : (1) for and on behalf of the undersigned, in the capacity of the undersigned as an officer of Tandem Diabetes Care, Inc. (the “Company”) to execute Forms 3, 4 and 5 under Section 16 (a) of the Securities Exchange Act of 1934, as amended (the “Exchange Act”) and the rules and regulations therein; (2) perform and perform all acts for and on behalf of the undersigned that may be necessary or desirable in order to complete and execute such Forms 3, 4s, and 5s, and timely filing this form with the SEC and any stock exchange or similar agency; ; and (3) take any other action whatsoever in connection with the foregoing which, in the opinion of such an actual attorney, may be useful in the best interests of the undersigned or required by law, it is understood that the documents filed by such attorney in Names of the undersigned in accordance with this power of attorney must be executed in such a form and must contain the conditions that such attorney may actually approve in such attorney. in fact at discretion. Indeed, the undersigned hereby grants any such attorney full authority and authority to do and carry out any particular act or matter whatever is necessary, necessary or appropriate to fully exercise the rights and authority granted herein in any way such as The undersigned could or could do so, when present in person, with full powers of substitution and revocation, and hereby certify and certify that any such actual attorney or the agents or proxies of any such actual attorney are granted by virtue of this power of attorney and those granted herein Rights and powers to do or cause to do so lawfully. The undersigned acknowledges that any of the aforementioned lawyers who act in this capacity at the undersigned’s request neither assumes the undersigned’s responsibility for compliance with Section 16 of the Stock Exchange Act, nor does the company assume any responsibility for compliance with Section 16 of the Stock Exchange Act. I, the undersigned, agree that each of these actual lawyers will be able to rely entirely on information that the undersigned will provide orally or in writing to any such actual lawyer. The undersigned also undertakes to indemnify the company and any such attorney from any loss, claim, damage or liability (or actions relating thereto) that may arise from a false statement or omission of the necessary or based on facts in the information provided by the Signed such an actual attorney for the purpose of providing, confirming, serving and filing Forms 3, 4s, or 5s (including any changes to them), and agrees to reimburse the Company and each of such actual attorneys for any legal or all other costs reasonably incurred in connection with investigating or defending against such loss, claim, damage, liability or action. DocuSign Envelope ID: 332B119E-6C17-46F5-8281-FC523ADC9323 This power of attorney shall remain in full force and effect until the undersigned is no longer required to submit Forms 3, 4s and 5s in relation to the undersigned’s holdings and transactions in securities to be submitted issued by the company, unless the undersigned has previously revoked this in a signed document that was served on the aforementioned actual lawyers. IN WITNESS WHEREOF, the undersigned initiated the enforcement of this power of attorney from March 2, 2021. From: Name: Dick P. Allen DocuSign
