SEC FORM 3 SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person*
Young James Emmett

(Last) (First) (Middle)
6272 W. 91ST AVE.

(Street)
WESTMINSTER CO 80031

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
01/06/2025
3. Issuer Name and Ticker or Trading Symbol
TriSalus Life Sciences, Inc. [ TLSI ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Chief Financial Officer
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 9,226(1) D
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Employee Stock Option (right to buy) (2) 10/08/2033 Common Stock 43,000 $4.95 D
Employee Stock Option (right to buy) (3) 02/11/2034 Common Stock 12,000 $9.5 D
Explanation of Responses:
1. Includes grant of Restricted Stock Units for 6,000 shares (the "RSU Award") payable solely in common stock of the Issuer. The shares subject to the RSU Award shall vest in equal annual installments beginning on February 12, 2024 and will become fully vested on February 12, 2028.
2. One-fourth (1/4th) of the shares subject to the option shall vest on the one-year anniversary of the vesting commencement date of August 28, 2023, and 1/36th of the remaining shares shall vest equally each month thereafter on the same day of the month as the vesting commencement date.
3. One-fourth (1/4th) of the shares subject to the option shall vest on the one-year anniversary of the vesting commencement date of February 12, 2024, and 1/36th of the remaining shares shall vest equally each month thereafter on the same day of the month as the vesting commencement date.
/s/ James Emmett Young 01/15/2025
** Signature of Reporting Person 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 5 (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).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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