SEC FORM 4 SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
McNamara Robert

(Last) (First) (Middle)
C/O ALPHA TEKNOVA, INC.
2451 BERT DRIVE

(Street)
HOLLISTER CA 95023

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
Alpha Teknova, Inc. [ TKNO ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
06/02/2023
4. 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
Rule 10b5-1(c) Transaction Indication

  
Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan that is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10.
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 06/02/2023 A 18,815(1) A $0.0 28,172 D
Common Stock 08/31/2023 D 18,815(2) D $0.0 9,357 D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Non-Qualified Stock Option (right to buy) $16 08/31/2023 D 12,292(3) (4) 06/24/2031 Common Stock 12,292 $0.0 31,959 D
Non-Qualified Stock Option (right to buy) $16 11/30/2023 D 31,959(5) (4) 06/24/2031 Common Stock 31,959 $0.0 0 D
Explanation of Responses:
1. Represents restricted stock units granted on June 2, 2023. Shares subject to the award vest on the first anniversary of the grant date.
2. Reflects the forfeiture of 18,815 restricted stock units in connection with the Reporting Person's resignation from the Board of Directors of Alpha Teknova, Inc., effective August 31, 2023.
3. Forfeiture of unvested stock options upon the effective date of the Reporting Person's resignation from the Board of Directors.
4. On June 24, 2021, the Reporting Person was granted 44,251 stock options. 1/3rd of the original number of shares subject to the option shall vest on the first anniversary of the grant date and the remaining shares subject to the option shall vest in equal monthly installments thereafter over 24 months.
5. Forfeiture of vested stock options after the expiration of the three-month exercise period following the effective date of the Reporting Person's resignation from the Board of Directors.
By: Damon A. Terrill For: Robert Edward McNamara 02/06/2024
** 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 4 (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.