Bronwyn Evans - 21 May 2025 Form 4 Insider Report for EBR Systems, Inc. (EBRCZ)

Reporting relationship: Director
Issuer ticker: EBRCZ
Reported as of: 21 May 2025
Net transaction value: $0
SEC form: 4
Accepted by SEC: 22 May 2025, 20:33:09 UTC
Prior SEC filing: 26 Nov 2024
Next SEC filing: 20 Jun 2025
Source filing: View source filing
Reporting owner signature: /s/ Gary W Doherty, Attorney-in-Fact

Key filing fact

Bronwyn Evans filed Form 4 for EBR Systems, Inc. (EBRCZ) on 22 May 2025.

Key facts

This page summarizes Bronwyn Evans's Form 4 filing for EBR Systems, Inc. (EBRCZ).
1 reported transaction and 1 derivative row are listed below.
Accepted by SEC: 22 May 2025, 20:33.

Change

Previous filing in this sequence was filed on 26 Nov 2024.
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 0002037266 Primary reporting owner

Evans Bronwyn

Relationship: Director
Address: 480 OAKMEAD PARKWAY, SUNNYVALE
Signature: /s/ Gary W Doherty, Attorney-in-Fact
Signature date: 22 May 2025

Reported non-derivative transactions

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

EBRCZ holding

Common Stock

No transaction description listed

Transaction value
Shares
Change %
Price
Shares after: 325,783
Date: 21 May 2025
Ownership: By Bronwyn Evans and Peter Douglas Gordon
Footnotes: F1, F2

Reported derivative securities

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

EBRCZ transaction Derivative

Stock Option (right to buy)

Award

Transaction value: $0
Shares: +175,781
Change %
Price: $0.000000
Shares after: 175,781
Date: 21 May 2025
Ownership: By Bronwyn Evans and Peter Douglas Gordon
Underlying class: Common Stock
Underlying amount: 175,781
Exercise price: $1.04
Footnotes: F3, F4, F5

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

Additional SEC filing notes

Filing notes and footnotes

Explanation of responses 5 footnotes

Footnote 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.

Footnote F2

Includes 150,000 shares previously owned directly which were contributed to Bronwyn Evans and Peter Douglas Gordon.

Footnote F3

The exercise price was determined and approved by the Board of Directors on March 18, 2025, subject to approval by the Company's stockholders at the 2025 annual meeting of stockholders (including any adjournment or postponement thereof) in accordance with the Listing Rules of the ASX.

Footnote F4

The Board of Directors approved the grant on March 18, 2025, subject to approval by the Company's stockholders at the 2025 annual meeting of stockholders (including any adjournment or postponement thereof) in accordance with the Listing Rules of the ASX.

Footnote F5

The option vests in 1/12 equal monthly installments as measured from 5/21/2025, subject to continued employment or service through each such date.