David Lawrence Blue - 01 Aug 2025 Form 4 Insider Report for SHOULDER INNOVATIONS, INC. (SI)

Role
Officer Title: Chief Customer Experience Officer
Signature
Jeffrey Points, as Attorney-in-Fact
Issuer symbol
SI
Transactions as of
01 Aug 2025
Net transactions value
$0
Form type
4
Filing time
05 Aug 2025, 16:05:14 UTC
Previous filing
30 Jul 2025
Next filing
15 Sep 2025
SEC
View on sec.gov

Reporting Owners (1)

Name Relationship Address Signature Signature date CIK
Blue David Lawrence Officer Title: Chief Customer Experience Officer C/O SHOULDER INNOVATIONS, INC., 1535 STEELE AVENUE SW, SUITE B, GRAND RAPIDS Jeffrey Points, as Attorney-in-Fact 05 Aug 2025 0002071751

Transactions Table

Type Sym Class Transaction Value $ Shares Change % * Price $ Shares After Date Ownership Footnotes
transaction SI Common Stock Conversion of derivative security +43,937 43,937 01 Aug 2025 Direct F1

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 SI Series Seed Convertible Preferred Stock Conversion of derivative security -100,000 -100% 0 01 Aug 2025 Common Stock 5,241 By David Lawrence Blue Living Trust F1
transaction SI Series A Convertible Preferred Stock Conversion of derivative security -346,333 -100% 0 01 Aug 2025 Common Stock 18,151 By David Lawrence Blue Living Trust F1
transaction SI Series B Convertible Preferred Stock Conversion of derivative security -308,916 -100% 0 01 Aug 2025 Common Stock 16,190 By David Lawrence Blue Living Trust F1
transaction SI Series C Convertible Preferred Stock Conversion of derivative security -46,512 -100% 0 01 Aug 2025 Common Stock 2,437 By David Lawrence Blue Living Trust F1
transaction SI Series E Convertible Preferred Stock Conversion of derivative security -36,614 -100% 0 01 Aug 2025 Common Stock 1,918 By David Lawrence Blue Living Trust F1
* An asterisk sign (*) next to the price indicates that the price is likely invalid.

Explanation of Responses:

Id Content
F1 Immediately prior to the closing of the Issuer's initial public offering, the shares of preferred stock of the Issuer automatically converted into shares of Common Stock on a one-for-0.052410901 basis.

Remarks:

Officer Title: Chief Customer Experience Officer