Allan R. Will - Sep 30, 2024 Form 3/A - Amendment Insider Report for EBR Systems, Inc. (EBRCZ)

Role
Director
Signature
/s/ Gary W Doherty, Attorney-in-Fact
Stock symbol
EBRCZ
Transactions as of
Sep 30, 2024
Transactions value $
$0
Form type
3/A - Amendment
Date filed
5/22/2025, 08:34 PM
Date Of Original Report
Sep 30, 2024
Previous filing
Feb 1, 2024
Next filing
Jan 2, 2025
SEC
View on sec.gov

Reporting Owners (1)

Name Relationship Address Signature Signature date CIK
Will Allan R Director 480 OAKMEAD PARKWAY, SUNNYVALE /s/ Gary W Doherty, Attorney-in-Fact 2025-05-22 0001367902

Transactions Table

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 EBRCZ Stock Option (right to buy) Sep 30, 2024 Common Stock 2.31M $0.14 Direct F4
holding EBRCZ Stock Option (right to buy) Sep 30, 2024 Common Stock 58.5K $0.16 Direct F4
holding EBRCZ Stock Option (right to buy) Sep 30, 2024 Common Stock 171K $0.80 Direct F5
holding EBRCZ Stock Option (right to buy) Sep 30, 2024 Common Stock 182K $0.44 Direct F6
holding EBRCZ Stock Option (right to buy) Sep 30, 2024 Common Stock 164K $0.55 Direct F7
holding EBRCZ Warrant (right to buy) Sep 30, 2024 Common Stock 63.8K $0.59 By the Allan R. Will Trust U/A Dtd 6/14/2012
holding EBRCZ Warrant (right to buy) Sep 30, 2024 Common Stock 63.8K $0.59 By the Allan R. Will Trust U/A Dtd 6/14/2012
holding EBRCZ Warrant (right to buy) Sep 30, 2024 Common Stock 25.5K $0.59 By the Allan R. Will Trust U/A Dtd 6/14/2012
holding EBRCZ Warrant (right to buy) Sep 30, 2024 Common Stock 48.4K $0.59 By the Allan R. Will Trust U/A Dtd 6/14/2012
holding EBRCZ Warrant (right to buy) Sep 30, 2024 Common Stock 48.4K $0.59 By the Allan R. Will Trust U/A Dtd 6/14/2012
* An asterisk sign (*) next to the price indicates that the price is likely invalid.

Explanation of Responses:

Id Content
F1 Represents shares of the Issuer's common stock underlying the same amount of Chess Depositary Interests ("CDIs"). The CDIs are traded on the Australian Securities Exchange (the "ASX") and are held by CHESS Depositary Nominees Pty, Limited, a subsidiary of ASX Limited, the company that operates the ASX.
F2 On September 30, 2024, the reporting person mistakenly filed a Form 3 reporting the indirect ownership of 628,000 shares of common stock. After further analysis, it was determined that Mr. Will does have 600,000 shares of indirect beneficial ownership of the Issuer's common stock held by Taphne Ann Lux and underlying the same amount of CDIs.
F3 Family Member
F4 Fully Vested.
F5 1/3 of the shares subject to the stock option vest on the one-year anniversary as measured from 10/1/2021, and the remainder of the shares vest in 24 equal monthly installments thereafter, subject to continued employment or service through each such date. If applicable, vesting accelerates as provided in, and subject to the terms and conditions of, that certain Severance and Change of Control Agreement between the Issuer and the Reporting Person, as may be amended from time to time.
F6 1/12 of the Option vests in equal monthly installments as measured from 5/22/2023, subject to continued employment or service through each such date. If applicable, vesting accelerates as provided in, and subject to the terms and conditions of, that certain Severance and Change of Control Agreement between the Issuer and the Reporting Person, as may be amended from time to time.
F7 1/12 of the Option vests in equal monthly installments as measured from 5/29/2024, subject to continued employment or service through each such date. If applicable, vesting accelerates as provided in, and subject to the terms and conditions of, that certain Severance and Change of Control Agreement between the Issuer and the Reporting Person, as may be amended from time to time.