Rebecca Ann Petersen - 01 Jul 2025 Form 3 Insider Report for CapsoVision, Inc (CV)

Role: Director of Clinical Affairs
Signature: /s/ Tai Vivatvaraphol, Attorney-in-Fact for Rebecca Petersen
Issuer symbol: CV
Transactions as of: 01 Jul 2025
Net transactions value: $0
Form type: 3
Filing time: 01 Jul 2025, 21:32:48 UTC
Next filing: 22 Aug 2025
SEC: View on sec.gov

Reporting Owners (1)

Name	Relationship	Address	Signature	Signature date	CIK
Petersen Rebecca Ann	Director of Clinical Affairs	C/O CAPSOVISION, INC., 18805 COX AVENUE, SUITE 250, SARATOGA	/s/ Tai Vivatvaraphol, Attorney-in-Fact for Rebecca Petersen	01 Jul 2025	0002075458

Derivative Securities (e.g., puts, calls, warrants, options, convertible securities)

Type	Sym	Class	Transaction	Value $	Shares	Change %	* Price $	Shares After	Date	Underlying Class	Amount	Exercise Price	Ownership	Footnotes
holding	CV	Stock Option (right to buy)							01 Jul 2025	Common Stock	25,000	$0.1100	Direct	F1, F2
holding	CV	Stock Option (right to buy)							01 Jul 2025	Common Stock	70,000	$0.1100	Direct	F2, F3

* An asterisk sign (*) next to the price indicates that the price is likely invalid.

Explanation of Responses:

Id	Content
F1	The derivative security is fully vested.
F2	The number of underlying shares of common stock reported in Column 3 and the exercise price reported in Column 4 do not reflect a one-for-3.33 reverse stock split, to be effective immediately prior to the closing to the Issuer's initial public offering.
F3	The options vested as to 25% of the shares on April 1, 2023 and as to the remaining 75% of the shares in 36 equal monthly installments thereafter through April 1, 2026, subject to continued service to the Issuer on each such date. The options, to the extent then outstanding and unvested, will vest in full upon a change in control of the Issuer.

Remarks:

Exhibit 24 - Power of Attorney