Anil K. Singhal Form 3 TriSalus Life Sciences / Anil K. Singhal ownership change

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^*

Singhal Anil K.

(Last) (First) (Middle)

6272 W. 91ST AVENUE

(Street)

WESTMINSTER CO 80031

(City) (State) (Zip)

2. Date of Event Requiring Statement (Month/Day/Year)
08/10/2023

3. Issuer Name and Ticker or Trading Symbol
TriSalus Life Sciences, Inc. [ TLSI ]

4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

X	Director	10% Owner
	Officer (give title below)	Other (specify below)

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)

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
Stock Option (right to buy)	(1)	07/23/2028	Common Stock	3,707(2)	1.22	D
Stock Option (right to buy)	(3)	04/20/2031	Common Stock	1,977(2)	0.41	D
Stock Option (right to buy)	(4)	04/20/2031	Common Stock	1,235(2)	0.41	D
Stock Option (right to buy)	(5)	01/18/2032	Common Stock	12,359(2)	2.43	D

Explanation of Responses:

1. The shares subject to this stock option became fully vested on July 24, 2020.

2. The securities reported herein were acquired by the Reporting Person prior to the Reporting Person becoming a director of the Issuer. The Reporting Person was appointed as a director of the Issuer effective immediately after the effective time of the Merger (as defined in that certain Agreement and Plan of Merger, dated as of November 11, 2022, as amended, by and among the Issuer, MTAC Merger Sub, Inc., and TriSalus Operating Life Sciences, Inc.).

3. The shares subject to this stock option shall vest in equal quarterly installments over three years, with 1/12th of the total number of shares subject to the option vesting on each quarterly anniversary of the vesting commencement date of January 1, 2021, subject to the Reporting Person's continued service with the Issuer on each respective vesting date.

4. The shares subject to this stock option vest in 48 equal monthly installments from April 15, 2020, the vesting commencement date, subject to the Reporting Person's continued service with the Issuer on each respective vesting date.

5. The shares subject to this stock option vest in 48 equal monthly installments from January 19, 2022, the vesting commencement date, subject to the Reporting Person's continued service with the Issuer on each respective vesting date.

Remarks:

	/s/ Sean Murphy, Attorney-in-Fact for Anil Singhal	08/14/2023
	** 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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