Sheryle Bolton - Jun 14, 2022 Form 4/A - Amendment Insider Report for Tivic Health Systems, Inc. (TIVC)

Role: Director
Signature: /s/ Jennifer Ernst, attorney-in-fact
Stock symbol: TIVC
Transactions as of: Jun 14, 2022
Transactions value $: $0
Form type: 4/A - Amendment
Date filed: 6/21/2022, 05:24 PM
Date Of Original Report: Jun 16, 2022
Previous filing: Dec 16, 2021
Next filing: Jun 16, 2023

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
transaction	TIVC	Employee Stock Option (Right to Buy)	Award	$0	+40K		$0.00	40K	Jun 14, 2022	Common Stock	40K	$1.75	Direct	F1

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

Explanation of Responses:

Id	Content
F1	This Amendment No. 1 ("Form 4/A") to the Form 4 filed by the reporting person on June 16, 2022 (the "Original Form 4") is being filed to correct an administrative error, resulting in the incorrect versting schedule being included for the option. As reflected in this Form 4/A, the option vests as follows: (i) 50% on the first anniversary of the grant date, (ii) 25% on the second anniversary of the grant date, and (iii) 25% on the third anniversary of the grant date.

Content

This Amendment No. 1 ("Form 4/A") to the Form 4 filed by the reporting person on June 16, 2022 (the "Original Form 4") is being filed to correct an administrative error, resulting in the incorrect versting schedule being included for the option. As reflected in this Form 4/A, the option vests as follows: (i) 50% on the first anniversary of the grant date, (ii) 25% on the second anniversary of the grant date, and (iii) 25% on the third anniversary of the grant date.