13D Filing: Kim D Blickenstaff and Tandem Diabetes Care Inc (NASDAQ:TNDM)

Page 2 of 10 – SEC Filing


CUSIP No. 875372 104 13D Page
2
of 10 Pages
  1. 

NAMES OF
REPORTING PERSONS

KIM D. BLICKENSTAFF

  2.

CHECK THE APPROPRIATE BOX IF A MEMBER
OF A GROUP (SEE INSTRUCTIONS)

(a)  ☐        (b)  ☐

  3.

SEC USE ONLY

  4.

SOURCE OF FUNDS (see instructions)

PF

  5.

CHECK IF DISCLOSURE OF LEGAL
PROCEEDINGS IS REQUIRED PURSUANT TO ITEM 2(d) OR 2(e) (see instructions)  ☐

  6.

CITIZENSHIP OR PLACE OF
ORGANIZATION

USA

NUMBER OF

SHARES

BENEFICIALLY

OWNED BY

EACH

REPORTING

PERSON

WITH

  7. 

SOLE VOTING POWER

1,518,468

  8.

SHARED VOTING POWER

2,143,572

  9.

SOLE DISPOSITIVE POWER

1,518,468

10.

SHARED DISPOSITIVE POWER

2,143,572

11.

AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON

3,662,040 (1)(2)

12.

CHECK IF THE AGGREGATE AMOUNT IN ROW
(11) EXCLUDES CERTAIN SHARES (see instructions)  ☐

13.

PERCENT OF CLASS REPRESENTED BY AMOUNT
IN ROW (11)

7.1% (1)(2)(3)(4)

14.

TYPE OF REPORTING PERSON (see
instructions)

IN

(1) This amount reflects the number of shares of common stock, par value $0.001 per share, of the Issuer (the Common Stock) that may be deemed beneficially owned by the Reporting Person.
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