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    SEC Form SC 13G filed by TriSalus Life Sciences Inc.

    10/21/24 8:25:05 AM ET
    $TLSI
    Medical Specialities
    Health Care
    Get the next $TLSI alert in real time by email
    SC 13G 1 tm2426403d1_sc13g.htm SC 13G

     

     

     

    UNITED STATES

    SECURITIES AND EXCHANGE COMMISSION

    Washington, D.C. 20549

     

     

    SCHEDULE 13G

     

    Under the Securities Exchange Act of 1934

     

    TriSalus Life Sciences Inc.

    (Name of Issuer)

     

    Common stock

    (Title of Class of Securities)

     

    89680M101

    (CUSIP Number)

     

    September 30, 2024

    (Date of Event Which Requires Filing of this Statement)

     

     

    Check the appropriate box to designate the rule pursuant to which this Schedule is filed:

     

    x Rule 13d-1(b)

     

    ¨Rule 13d-1(c)

     

    ¨Rule 13d-1(d)

     

    *The remainder of this cover page shall be filled out for a reporting person’s initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter the disclosures provided in a prior cover page.

     

    The information required in the remainder of this cover page shall not be deemed to be “filed” for the purpose of Section 18 of the Securities Exchange Act of 1934 (“Act”) or otherwise subject to the liabilities of that section of the Act, but shall be subject to all other provisions of the Act (however, see the Notes).

     

     

     

     

     

    CUSIP No. 89680M101

     

    1

    Name of Reporting Person:

     

    Lombard International Assurance S.A. 

     

    2

    Check the Appropriate Box if a Member of a Group (see instructions)

    (a)     ¨     (b)     x

     

    3

    SEC Use Only

     

    4

    Citizenship or Place of Organization

     

    Luxembourg 

    Number
    of
    Shares
    Beneficially
    Owned
    by
    Each
    Reporting
    Person
    With :
    5

    Sole Voting Power

     

    1,975,5881

    6

    Shared Voting Power

     

    None  

    7

    Sole Dispositive Power

     

    1,975,5881

    8

    Shared Dispositive Power

     

    None  

    9

    Aggregate Amount Beneficially Owned by Each Reporting Person

     

    1,975,5881

    10

     

    Check if the Aggregate Amount in Row (9) Excludes Certain Shares ¨

    11

     

    Percent of Class Represented by Amount in Row (9)

     

    6.74%2

    12

     

    Type of Reporting Person

     

    FI 

     

     

    1 Consist of (i) 1,387,588 shares held directly by Lombard International Assurance S.A. under policies COMANG, KREMAN, ORANGE, P28212, P41357, P47082, P47083, P47084, P47472, P54194, P56278, P69562, S78336 and SKAFUN and (ii)588,000 shares of New TriSalus Common Stock issuable upon conversion of shares of Series A Convertible Preferred Stock held by Lombard International Assurance S.A. under policies P47082, P47083, P47084, P47473 and P78406 as a Preferred Stock PIPE Investor.

     

    2 Represents the percentage ownership based on 29,311,498 shares of common stock of TriSalus issued and outstanding as of September 30, 2024. 

     

     

     

    Item 1(a). Name of Issuer.

     

    TriSalus Life Sciences Inc. (the “Issuer”).

     

    Item 1(b).Address of Issuer’s Principal Executive Offices.

     

    6272 W. 91st Ave., Westminster, Colorado 80031

     

    Item 2(a).Names of Persons Filing.

     

    This Schedule 13G is filed on behalf of Lombard International Assurance S.A.

     

    Item 2(b).Address or Principal Business Office or, if none, Residence.

     

    Lombard International Assurance S.A.
    4, rue Lou Hemmer

    L-1748 Luxembourg
    Luxembourg

     

    Item 2(c).Citizenship.

     

    Luxembourg

     

    Item 2(d).Title of Class of Securities.

     

    Common Stock

     

    Item 2(e).CUSIP Number.

     

    8968M101

     

    Item 3.If this statement is filed pursuant to Rule 13d-1(b), or 13d-3(b) or (c), check whether the person filing is a:

     

        ¨ Not Applicable
           
      (a) ¨ Broker or dealer registered under section 15 of the Act;
           
      (b) ¨ Bank as defined in section 3(a)(6) of the Act;
           
      (c) ¨ Insurance company as defined in section 3(a)(19) of the Act;
           
      (d) ¨ Investment company registered under section 8 of the Investment Company Act of 1940;
           
      (e) ¨ An investment adviser in accordance with Rule 13d-1(b)(1)(ii)(E);
           
      (f) ¨ An employee benefit plan or endowment fund in accordance with Rule 13d-1(b)(1)(ii)(F);
           
      (g) ¨ A parent holding company or control person in accordance with Rule 13d-1(b)(1)(ii)(G);
           
      (h) ¨ A savings association as defined in Section 3(b) of the Federal Deposit Insurance Act;
           
      (i) ¨ A church plan that is excluded from the definition of an investment company under section 3(c)(14) of the Investment Company Act of 1940;
           
      (j) x A non-U.S. institution in accordance with Rule 13d-1(b)(1)(ii)(J);
           
      (k) ¨ Group, in accordance with Rule 13d-1(b)(1)(ii)(K).

     

     

     

    Item 4.Ownership:

     

    (a)Amount beneficially owned:

     

    1,975,588 shares

     

    (b)Percent of class:

     

    6.74%

     

    (c)Number of shares as to which the person has:

     

      (i)Sole power to vote or to direct the vote
      1,975,588

     

      (ii)Shared power to vote or to direct the vote
      None

     

      (iii)Sole power to dispose or to direct the vote
      1,975,588

     

      (iv)Shared power to dispose or to direct the disposition of
      None

     

    Item 5.Ownership of Five Percent or Less of a Class.

     

    If this statement is being filed to report the fact that as of the date hereof the reporting person has ceased to be the beneficial owner of more than five percent of the class of securities, check the following: Not applicable

     

    Item 6.Ownership of More than Five Percent on Behalf of Another Person.

     

    Not applicable.

     

    Item 7.Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on By the Parent Holding Company or Control Person.

     

    Not applicable.

     

    Item 8.Identification and Classification of Members of the Group.

     

    Not applicable

     

    Item 9.Notice of Dissolution of Group.

     

    Not applicable.

     

    Item 10.Certifications.

     

    Not applicable.

     

     

     

    SIGNATURE

     

    After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct.

     

    Dated: 17 October 2024 Lombard International Assurance S.A.
       
      Nadine Provost – Director of Investment Administration
       
      /s/ Nadine Provost
      Signed by: Nadine Provost
      EMail: [email protected]
      Signing time: 17-10-2024 16:28:58
      IP address: 192.168.2.57
       
      Stephan Christmann – Head of Private Markets Monitoring
       
      /s/ Stephan Christmann
      Signed by: Stephan Christmann
      EMail: [email protected]
      Signing time: 18-10-2024 14:45:51
      IP address: 192.168.2.56

     

     

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