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