Harari Eliyahou Et al - 03 Jul 2025 Form 4/A - Amendment Insider Report for CapsoVision, Inc (CV)

Reporting relationship
10%+ Owner
Issuer ticker
CV
Reported as of
03 Jul 2025
Net transaction value
$0
Source evidence Original filing metadata and source links for verification. 6 source fields
SEC form
4/A - Amendment
Accepted by SEC
08 Jul 2025, 21:01:41 UTC
Original report date
08 Jul 2025
Prior SEC filing
02 Jul 2025
Next SEC filing
26 Mar 2026
Source filing
View source filing
Reporting owner 1 detail
Reporting owner signature
/s/ Peter Bergman, Attorney-in-Fact for Eliyahou Harari

Key filing fact

Harari Eliyahou Et al filed Form 4/A - Amendment for CapsoVision, Inc (CV) on 08 Jul 2025.

Key facts

  • This page summarizes Harari Eliyahou Et al's Form 4/A - Amendment filing for CapsoVision, Inc (CV).
  • 13 reported transactions and 10 derivative rows are listed below.
  • Accepted by SEC: 08 Jul 2025, 21:01.

Change

  • Previous filing in this sequence was filed on 02 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/A - Amendment disclosures.

View source filing

Reporting Owners (1)

CIK 0001009165 Primary reporting owner

HARARI ELIYAHOU ET AL

Relationship
10%+ Owner
Address
225 CHARCOT, SAN JOSE
Signature
/s/ Peter Bergman, Attorney-in-Fact for Eliyahou Harari
Signature date
08 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
+3,186,904
Change %
Price
Shares after
3,186,904
Date
03 Jul 2025
Ownership
By trust.
Footnotes
F1, F2
CV transaction

Common Stock

Conversion of derivative security

Transaction value
Shares
+517,759
Change %
Price
Shares after
517,759
Date
03 Jul 2025
Ownership
By trust.
Footnotes
F1, F3
CV transaction

Common Stock

Conversion of derivative security

Transaction value
Shares
+517,759
Change %
Price
Shares after
517,759
Date
03 Jul 2025
Ownership
By trust.
Footnotes
F1, F4

Reported derivative securities

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

CV transaction Derivative

Series D-1 Preferred Stock

Conversion of derivative security

Transaction value
$0
Shares
-222,222
Change %
-100%
Price
$0.000000
Shares after
0
Date
03 Jul 2025
Ownership
By trust.
Underlying class
Common Stock
Underlying amount
66,733
Exercise price
Footnotes
F1, F2
CV transaction Derivative

Series D-2 Preferred Stock

Conversion of derivative security

Transaction value
$0
Shares
-934,588
Change %
-100%
Price
$0.000000
Shares after
0
Date
03 Jul 2025
Ownership
By trust.
Underlying class
Common Stock
Underlying amount
280,657
Exercise price
Footnotes
F1, F2
CV transaction Derivative

Series E Preferred Stock

Conversion of derivative security

Transaction value
$0
Shares
-434,782
Change %
-100%
Price
$0.000000
Shares after
0
Date
03 Jul 2025
Ownership
By trust.
Underlying class
Common Stock
Underlying amount
130,565
Exercise price
Footnotes
F1, F2
CV transaction Derivative

Series F-1 Preferred Stock

Conversion of derivative security

Transaction value
$0
Shares
-434,783
Change %
-100%
Price
$0.000000
Shares after
0
Date
03 Jul 2025
Ownership
By trust.
Underlying class
Common Stock
Underlying amount
130,565
Exercise price
Footnotes
F1, F2
CV transaction Derivative

Series F-2 Preferred Stock

Conversion of derivative security

Transaction value
$0
Shares
-2,000,000
Change %
-100%
Price
$0.000000
Shares after
0
Date
03 Jul 2025
Ownership
By trust.
Underlying class
Common Stock
Underlying amount
600,601
Exercise price
Footnotes
F1, F2
CV transaction Derivative

Series G Preferred Stock

Conversion of derivative security

Transaction value
$0
Shares
-740,741
Change %
-100%
Price
$0.000000
Shares after
0
Date
03 Jul 2025
Ownership
By trust.
Underlying class
Common Stock
Underlying amount
222,445
Exercise price
Footnotes
F1, F2
CV transaction Derivative

Series G-1 Preferred Stock

Conversion of derivative security

Transaction value
$0
Shares
-1,206,898
Change %
-100%
Price
$0.000000
Shares after
0
Date
03 Jul 2025
Ownership
By trust.
Underlying class
Common Stock
Underlying amount
362,432
Exercise price
Footnotes
F1, F2
CV transaction Derivative

Series H Preferred Stock

Conversion of derivative security

Transaction value
$0
Shares
-4,638,377
Change %
-100%
Price
$0.000000
Shares after
0
Date
03 Jul 2025
Ownership
By trust.
Underlying class
Common Stock
Underlying amount
1,392,906
Exercise price
Footnotes
F1, F2
CV transaction Derivative

Series H Preferred Stock

Conversion of derivative security

Transaction value
$0
Shares
-1,724,139
Change %
-100%
Price
$0.000000
Shares after
0
Date
03 Jul 2025
Ownership
By trust.
Underlying class
Common Stock
Underlying amount
517,759
Exercise price
Footnotes
F1, F3
CV transaction Derivative

Series H Preferred Stock

Conversion of derivative security

Transaction value
$0
Shares
-1,724,139
Change %
-100%
Price
$0.000000
Shares after
0
Date
03 Jul 2025
Ownership
By trust.
Underlying class
Common Stock
Underlying amount
517,759
Exercise price
Footnotes
F1, F4
* marks a reported price that did not pass the local price check.

Additional SEC filing notes

Filing notes and footnotes

Section 16 status

Harari Eliyahou Et al is no longer subject to Section 16 filing requirements. Form 4 or Form 5 obligations may still apply in specific circumstances.

Explanation of responses 4 footnotes

Footnote F1

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

Footnote F2

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

Footnote F3

The securities are held by Harari 2010 Children Remainder Trust - MHG, for which the Reporting Person, together with his wife, are trustees.

Footnote F4

The securities are held by Harari 2010 Children Remainder Trust - DAH, for which the Reporting Person, together with his wife, are trustees.

SEC remarks

Amended to: - correct address of record - check box re no longer subject to Section 16

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