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PRCT Procept BioRobotics

Filed: 14 Sep 21, 7:17pm
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*
Nouri Alaleh

(Last) (First) (Middle)
C/O PROCEPT BIOROBOTICS CORPORATION
900 ISLAND DRIVE

(Street)
REDWOOD CITY CA 94065

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
09/14/2021
3. Issuer Name and Ticker or Trading Symbol
PROCEPT BioRobotics Corp [ PRCT ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
SVP, GEN COUNSEL, CORP. SEC.
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 43,064 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
Stock Option (Right to Buy) (1) 09/28/2028 Common Stock 87,575 4.5125 D
Stock Option (Right to Buy) (2) 12/12/2029 Common Stock 12,230 4.56 D
Stock Option (Right to Buy) (3) 08/10/2030 Common Stock 16,160 5.1775 D
Stock Option (Right to Buy) (4) 06/22/2031 Common Stock 16,232 7.2675 D
Explanation of Responses:
1. The Stock option was granted on September 28, 2018 and vests each monthly anniversary of July 9, 2018, the vesting commencement date, over a four year period, subject continued employment or service to the Issuer through the applicable vesting date.
2. The Stock option was granted on December 12, 2019 and vests on each monthly anniversary of the grant date over a four year period, subject continued employment or service to the Issuer through the applicable vesting date.
3. The Stock option was granted on August 10, 2020 and vests 12.5% on the six month anniversary of August 1, 2020 and the remainder on each monthly anniversary over a three and a half year period, subject continued employment or service to the Issuer through the applicable vesting date.
4. The Stock option was granted on June 22, 2021 and vests 25% on the six month anniversary of June 22, 2021 and the remainder vests on each monthly anniversary over a four year period, subject continued employment or service to the Issuer through the applicable vesting date.
Remarks:
Exhibit List: Exhibit 24 - Power of Attorney
/s/ Alaleh Nouri 09/14/2021
** 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.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.