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

Role
Chief Scientific Officer
Signature
/s/ Blake Gurfein
Stock symbol
TIVC
Transactions as of
Nov 10, 2021
Transactions value $
$0
Form type
3
Date filed
11/10/2021, 08:10 PM
Next filing
Dec 16, 2021

Transactions Table

Type Sym Class Transaction Value $ Shares Change % * Price $ Shares After Date Ownership Footnotes
holding TIVC Common Stock 120K Nov 10, 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) Nov 10, 2021 Common Stock 7.81K $0.12 Direct F1
holding TIVC Stock Option (Right to Buy) Nov 10, 2021 Common Stock 5.21K $0.12 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.