Jack E. Stover - 04 May 2026 Form 4 Insider Report for Profusa, Inc. (PFSA)

Reporting relationship: Director
Issuer ticker: PFSA
Reported as of: 04 May 2026
Net transaction value: $0
SEC form: 4
Accepted by SEC: 06 May 2026, 10:42:51 UTC
Prior SEC filing: 10 Mar 2026
Next 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 06 May 2026.

Key facts

This page summarizes Jack E. Stover's Form 4 filing for Profusa, Inc. (PFSA).
1 reported transaction and 1 derivative row are listed below.
Accepted by SEC: 06 May 2026, 10:42.

Change

Previous filing in this sequence was filed on 10 Mar 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: Director
Address: 626 BANCROFT WAY, SUITE A, BERKELEY
Signature: /s/ Jack Stover
Signature date: 06 May 2026

Reported derivative securities

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

PFSA transaction Derivative

Convertible Promissory Note

Purchase

Transaction value
Shares
Change %
Price
Shares after: $1,869,796
Date: 04 May 2026
Ownership: By NorthView Sponsor I LLC
Underlying class: Common Stock
Underlying amount: 5,342,274
Exercise price: $0.3500
Footnotes: F1, F2, F3, F4

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

Additional SEC filing notes

Filing notes and footnotes

Explanation of responses 4 footnotes

Footnote F1

The conversion price is equal to the greater of (i) 95% of the closing price of the Common Stock on the Conversion Date and (ii) $0.35 per share, pursuant to the Note Modification and Conversion Agreement dated April 24, 2026.

Footnote F2

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

Footnote F3

Represents the conversion of the entire outstanding principal balance of the Second Amended and Restated Promissory Note, dated April 6, 2026, in the amount of $1,869,796 into 5,342,274 shares of Common Stock, reflecting conversion at the $0.35 per share floor price.

Footnote F4

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