0000950170-24-096480.txt : 20240813
0000950170-24-096480.hdr.sgml : 20240813
20240813174846
ACCESSION NUMBER: 0000950170-24-096480
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20240809
FILED AS OF DATE: 20240813
DATE AS OF CHANGE: 20240813
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Bolton Sheryle
CENTRAL INDEX KEY: 0001418947
ORGANIZATION NAME:
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-41052
FILM NUMBER: 241203315
MAIL ADDRESS:
STREET 1: 55 ALMADEN BLVD
CITY: SAN JOSE
STATE: CA
ZIP: 95113
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Tivic Health Systems, Inc.
CENTRAL INDEX KEY: 0001787740
STANDARD INDUSTRIAL CLASSIFICATION: ELECTROMEDICAL & ELECTROTHERAPEUTIC APPARATUS [3845]
ORGANIZATION NAME: 08 Industrial Applications and Services
IRS NUMBER: 814016391
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 47685 LAKEVIEW BLVD
CITY: FREMONT
STATE: CA
ZIP: 94538
BUSINESS PHONE: (888)276-6888
MAIL ADDRESS:
STREET 1: 47685 LAKEVIEW BLVD
CITY: FREMONT
STATE: CA
ZIP: 94538
4
1
ownership.xml
4
X0508
4
2024-08-09
0001787740
Tivic Health Systems, Inc.
TIVC
0001418947
Bolton Sheryle
47685 LAKEVIEW BLVD.
FREMONT
CA
94538
true
false
false
false
false
Employee Stock Option (Right to Buy)
0.41
2024-08-09
4
A
false
3000
0
A
2034-08-08
Common Stock
3000
3000
D
The option vests in a series of twelve (12) successive equal monthly installments, rounded downward to the nearest whole share, from the grant date, such that 100% of the option will be vested upon the first anniversary of the grant date.
/s/ Jennifer Ernst, attorney-in-fact
2024-08-13