Tsai Chen Lung - 03 Jul 2025 Form 4 Insider Report for CapsoVision, Inc (CV)

Source evidence Original filing metadata and source links for verification. 5 source fields
SEC form
4
Accepted by SEC
07 Jul 2025, 17:27:36 UTC
Prior SEC filing
01 Jul 2025
Next SEC filing
17 Sep 2025
Source filing
View source filing
Reporting owner 1 detail
Reporting owner signature
/s/ Tai Vivatvaraphol, Attorney-in-Fact for Chen Lung Tsai

Key filing fact

Tsai Chen Lung filed Form 4 for CapsoVision, Inc (CV) on 07 Jul 2025.

Key facts

  • This page summarizes Tsai Chen Lung's Form 4 filing for CapsoVision, Inc (CV).
  • 5 reported transactions and 4 derivative rows are listed below.
  • Accepted by SEC: 07 Jul 2025, 17:27.

Change

  • Previous filing in this sequence was filed on 01 Jul 2025.
  • 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 0001307275 Primary reporting owner

Tsai Chen Lung

Relationship
Director
Address
C/O CAPSOVISION, INC., 18805 COX AVENUE, SUITE 250, SARATOGA
Signature
/s/ Tai Vivatvaraphol, Attorney-in-Fact for Chen Lung Tsai
Signature date
07 Jul 2025

Reported non-derivative transactions

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

CV transaction

Common Stock

Conversion of derivative security

Transaction value
Shares
+91,432
Change %
+381%
Price
Shares after
115,456
Date
03 Jul 2025
Ownership
By trust.
Footnotes
F1, F2

Reported derivative securities

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

CV transaction Derivative

Series B Preferred Stock

Conversion of derivative security

Transaction value
$0
Shares
-71,429
Change %
-100%
Price
$0.000000
Shares after
0
Date
03 Jul 2025
Ownership
By trust.
Underlying class
Common Stock
Underlying amount
21,450
Exercise price
Footnotes
F1, F2
CV transaction Derivative

Series D-1 Preferred Stock

Conversion of derivative security

Transaction value
$0
Shares
-55,555
Change %
-100%
Price
$0.000000
Shares after
0
Date
03 Jul 2025
Ownership
By trust.
Underlying class
Common Stock
Underlying amount
16,683
Exercise price
Footnotes
F1, F2
CV transaction Derivative

Series E Preferred Stock

Conversion of derivative security

Transaction value
$0
Shares
-86,956
Change %
-100%
Price
$0.000000
Shares after
0
Date
03 Jul 2025
Ownership
By trust.
Underlying class
Common Stock
Underlying amount
26,112
Exercise price
Footnotes
F1, F2
CV transaction Derivative

Series H Preferred Stock

Conversion of derivative security

Transaction value
$0
Shares
-90,534
Change %
-100%
Price
$0.000000
Shares after
0
Date
03 Jul 2025
Ownership
By trust.
Underlying class
Common Stock
Underlying amount
27,187
Exercise price
Footnotes
F1, F2
* marks a reported price that did not pass the local price check.

Additional SEC filing notes

Filing notes and footnotes

Explanation of responses 2 footnotes

Footnote F1

Each share of Series B preferred stock, Series D-1 preferred stock, Series E preferred stock and Series H preferred stock automatically converted into approximately 0.3003 shares of the Issuer's common stock upon the closing of the Issuer's initial public offering. The number of shares reported herein gives effect to a 1-for-3.33 reverse stock split of the Issuer's common stock effected by the Issuer on July 2, 2025 in connection with its initial public offering.

Footnote F2

The securities are held by The Tsai Family Trust, for which the Reporting Person, together with his wife, are trustees.

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