Jack E. Stover - 12 Aug 2026 Form 4 Insider Report for Profusa, Inc. (PFSA)

Reporting relationship: Chief Executive Officer
Issuer ticker: PFSA
Reported as of: 12 Aug 2026
Net transaction value: $0
SEC form: 4
Accepted by SEC: 19 Aug 2026, 20:13:53 UTC
Prior SEC filing: 14 Jul 2026
Source filing: View source filing
Reporting owner signature: /s/ Jack Stover

Key filing fact

Jack E. Stover filed Form 4 for Profusa, Inc. (PFSA) on 19 Aug 2026.

Key facts

This page summarizes Jack E. Stover's Form 4 filing for Profusa, Inc. (PFSA).
2 reported transactions and 1 derivative row are listed below.
Accepted by SEC: 19 Aug 2026, 20:13.

Change

Previous filing in this sequence was filed on 14 Jul 2026.
Current net transaction value: $0.

Research use

This tells you what this filing adds before you inspect full transaction and derivative tables.
You can trace every row back to the original SEC filing document.

Evidence

Filed on Form 4

Ownership activity is grounded in SEC Form 4 disclosures.

View source filing

Reporting Owners (1)

CIK 0001203603 Primary reporting owner

STOVER JACK E

Relationship: Chief Executive Officer
Address: 626 BANCROFT WAY, SUITE A, BERKELEY
Signature: /s/ Jack Stover
Signature date: 19 Aug 2026

Reported non-derivative transactions

Shares, units, or other non-derivative securities reported in this filing.

PFSA transaction

Common Stock

Conversion of derivative security

Transaction value
Shares: +301,991
Change %
Price: $4.28^*
Shares after: 301,991
Date: 12 Aug 2026
Ownership: By NorthView Sponsor I LLC
Footnotes: F1, F2, F3

PFSA holding

Common Stock

No transaction description listed

Transaction value
Shares
Change %
Price
Shares after: 73
Date: 12 Aug 2026
Ownership: Direct

Reported derivative securities

Options, warrants, convertible securities, or similar derivative positions disclosed in the filing.

PFSA transaction Derivative

Convertible Promissory Note

Conversion of derivative security

Transaction value
Shares
Change %
Price
Shares after: $577,275
Date: 12 Aug 2026
Ownership: By NorthView Sponsor I LLC
Underlying class: Common Stock
Underlying amount: 301,991
Exercise price: $4.28
Footnotes: F1, F2, F3, F4, F5, F6

^* marks a reported price that did not pass the local price check.

Additional SEC filing notes

Filing notes and footnotes

Explanation of responses 6 footnotes

Footnote F1

On August 12, 2026, 1,207,964 shares of Common Stock were issued upon conversion of a portion of the Convertible Promissory Note. Following a 1-for-4 reverse stock split effected after the conversion, the number of shares held became 301,991.

Footnote F2

The conversion price is equal to the higher of (i) $1.07 and (ii) the closing price of the Common Stock on the trading day immediately preceding the delivery of the Conversion Notice, as reported on The Nasdaq Stock Market, pursuant to Amendment No. 3 to the Note Modification and Conversion Agreement dated August 12, 2026. The pre-split conversion price of $1.07 per share is equivalent to $4.28 per share on a post-split basis following the 1-for-4 reverse stock split.

Footnote F3

Jack Stover is a manager of NorthView Sponsor I LLC and may be deemed to share beneficial ownership of the securities held by NorthView Sponsor I LLC. Mr. Stover disclaims beneficial ownership of such securities except to the extent of his pecuniary interest therein.

Footnote F4

Represents the conversion of $1,292,521 principal amount of the Convertible Promissory Note into 1,207,964 shares of Common Stock (301,991 shares on a post-split basis), reflecting conversion at the $1.07 per share ($4.28 per share on a post-split basis) price pursuant to the Conversion Notice dated August 12, 2026.

Footnote F5

The Note became convertible on May 4, 2026 (the Registration Effective Date), pursuant to Section 2.1 of the Note Modification and Conversion Agreement dated April 24, 2026.

Footnote F6

Represents the remaining principal balance of the Note following conversion.