Rebecca Ann Petersen - 18 Aug 2025 Form 4 Insider Report for CapsoVision, Inc (CV)

Reporting relationship: Director of Clinical Affairs
Issuer ticker: CV
Reported as of: 18 Aug 2025
Net transaction value: +$9,097
SEC form: 4
Accepted by SEC: 22 Aug 2025, 20:44:52 UTC
Prior SEC filing: 01 Jul 2025
Source filing: View source filing
Reporting owner signature: /s/ Tai Vivatvaraphol, Attorney-in-Fact for Rebecca Petersen

Key filing fact

Rebecca Ann Petersen filed Form 4 for CapsoVision, Inc (CV) on 22 Aug 2025.

Key facts

This page summarizes Rebecca Ann Petersen's Form 4 filing for CapsoVision, Inc (CV).
3 reported transactions and 2 derivative rows are listed below.
Accepted by SEC: 22 Aug 2025, 20:44.

Change

Previous filing in this sequence was filed on 01 Jul 2025.
Current net transaction value: +$9,097.

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 0002075458 Primary reporting owner

Petersen Rebecca Ann

Relationship: Director of Clinical Affairs
Address: C/O CAPSOVISION, INC., 18805 COX AVENUE, SUITE 250, SARATOGA
Signature: /s/ Tai Vivatvaraphol, Attorney-in-Fact for Rebecca Petersen
Signature date: 22 Aug 2025

Reported non-derivative transactions

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

CV transaction

Common Stock

Options Exercise

Transaction value: $9,097
Shares: +24,834
Change %
Price: $0.3663
Shares after: 24,834
Date: 18 Aug 2025
Ownership: Direct

Reported derivative securities

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

CV transaction Derivative

Stock Option (right to buy)

Options Exercise

Transaction value: $0
Shares: -7,507
Change %: -100%
Price: $0.000000
Shares after: 0
Date: 18 Aug 2025
Ownership: Direct
Underlying class: Common Stock
Underlying amount: 7,507
Exercise price: $0.3663
Footnotes: F1, F2, F3

CV transaction Derivative

Stock Option (right to buy)

Options Exercise

Transaction value: $0
Shares: -17,327
Change %: -82%
Price: $0.000000
Shares after: 3,694
Date: 18 Aug 2025
Ownership: Direct
Underlying class: Common Stock
Underlying amount: 17,327
Exercise price: $0.3663
Footnotes: F1, 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

These options were previously reported at exercise price of $0.11 per share. The exercise price reported herein gives effect to a 1-for-3.33 reverse stock split effected by the Issuer on July 2, 2025 in connection with its initial public offering.

Footnote F2

The option was granted on October 28, 2021 and is fully vested and exercisable as of the transaction date.

Footnote F3

There options were previously reported as covering 25,000 and 70,000 shares, respectively. The number of shares reported herein gives effect to a 1-for-3.33 reverse stock split effected by the Issuer on July 2, 2025 in connection with its initial public offering.

Footnote F4

The option was granted on March 23, 2022 and is partially vested and exercisable as of the transaction date.

SEC remarks

The Form 4 is being filed late due to an inadvertent administrative error.