0001104659-22-042855.txt : 20220405
0001104659-22-042855.hdr.sgml : 20220405
20220405171504
ACCESSION NUMBER: 0001104659-22-042855
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20220401
FILED AS OF DATE: 20220405
DATE AS OF CHANGE: 20220405
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Cai Veronica
CENTRAL INDEX KEY: 0001801322
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-41052
FILM NUMBER: 22808098
MAIL ADDRESS:
STREET 1: C/O CATALYST BIOSCIENCES, INC.
STREET 2: 611 GATEWAY BOULEVARD, SUITE 710
CITY: SOUTH SAN FRANCISCO
STATE: CA
ZIP: 94080
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Tivic Health Systems, Inc.
CENTRAL INDEX KEY: 0001787740
STANDARD INDUSTRIAL CLASSIFICATION: ELECTROMEDICAL & ELECTROTHERAPEUTIC APPARATUS [3845]
IRS NUMBER: 814016391
STATE OF INCORPORATION: CA
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 25821 INDUSTRIAL BLVD., SUITE 100
CITY: HAYWARD
STATE: CA
ZIP: 94545
BUSINESS PHONE: (888)276-6888
MAIL ADDRESS:
STREET 1: 25821 INDUSTRIAL BLVD., SUITE 100
CITY: HAYWARD
STATE: CA
ZIP: 94545
4
1
tm2211723d2_4.xml
OWNERSHIP DOCUMENT
X0306
4
2022-04-01
0
0001787740
Tivic Health Systems, Inc.
TIVC
0001801322
Cai Veronica
25821 INDUSTRIAL BLVD., SUITE 100
HAYWARD
CA
94545
0
1
0
0
Chief Financial Officer
Employee Stock Option (Right to Buy)
1.61
2022-04-01
4
A
0
117880
0
A
2032-03-31
Common Stock
117880
117880
D
The option vests as follows: (i) 25% one year from the grant date, and (ii) the remaining 75% in equal monthly installments over the 36 months thereafter.
/s/ Veronica Cai
2022-04-05