Blake Gurfein - 10 Nov 2021 Form 3 Insider Report for Tivic Health Systems, Inc. (TIVC)

Role
Chief Scientific Officer
Signature
/s/ Blake Gurfein
Issuer symbol
TIVC
Transactions as of
10 Nov 2021
Net transactions value
$0
Form type
3
Filing time
10 Nov 2021, 20:10:05 UTC
Next filing
16 Dec 2021
SEC
View on sec.gov

Transactions Table

Type Sym Class Transaction Value $ Shares Change % * Price $ Shares After Date Ownership Footnotes
holding TIVC Common Stock 119,979 10 Nov 2021 Direct

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 TIVC Stock Option (Right to Buy) 10 Nov 2021 Common Stock 7,813 $0.1200 Direct F1
holding TIVC Stock Option (Right to Buy) 10 Nov 2021 Common Stock 5,209 $0.1200 Direct F1
* An asterisk sign (*) next to the price indicates that the price is likely invalid.

Explanation of Responses:

Id Content
F1 The option vests as follows: (i) 25% on January 1, 2019, and (ii) the remaining 75% in equal monthly installments over the next 36 months.