STOCK TITAN

[Form 4] CapsoVision, Inc. Insider Trading Activity

Filing Impact
(Low)
Filing Sentiment
(Neutral)
Form Type
4
Rhea-AI Filing Summary

CapsoVision, Inc. reporting person Rebecca Ann Petersen acquired 24,834 shares of common stock and holds stock options adjusted for a recent reverse split. The Form 4 shows a purchase of 24,834 shares at $0.3663 per share on 08/18/2025, resulting in 24,834 shares beneficially owned directly. The filing also reports two option grants (7,507 and 17,327 underlying shares) with an exercise price of $0.3663, exercisable through 10/31/2031 and 03/22/2032; the options’ share counts and exercise price reflect a 1-for-3.33 reverse stock split tied to the issuer’s IPO. One option is fully vested and the other is partially vested. The Form 4 was filed late due to an administrative error.

Rebecca Ann Petersen, reporting person di CapsoVision, Inc., ha acquistato 24.834 azioni ordinarie e detiene opzioni su azioni rettificate in seguito a un raggruppamento azionario inverso. Il Form 4 riporta l'acquisto di 24.834 azioni al prezzo di $0.3663 per azione il 18/08/2025, portando il totale delle azioni detenute direttamente a 24.834. La comunicazione segnala inoltre due concessioni di opzioni (sottostanti 7.507 e 17.327 azioni) con prezzo di esercizio di $0.3663, esercitabili fino al 31/10/2031 e al 22/03/2032; i conteggi delle azioni delle opzioni e il prezzo di esercizio riflettono un raggruppamento azionario inverso 1-per-3,33 collegato all'IPO dell'emittente. Un'opzione è totalmente maturata, l'altra è parzialmente maturata. Il Form 4 è stato depositato in ritardo a causa di un errore amministrativo.

Rebecca Ann Petersen, persona informante de CapsoVision, Inc., adquirió 24.834 acciones ordinarias y posee opciones sobre acciones ajustadas por una consolidación inversa. El Formulario 4 muestra la compra de 24.834 acciones a $0.3663 por acción el 18/08/2025, resultando en 24.834 acciones poseídas de forma directa. La presentación también informa de dos adjudicaciones de opciones (7.507 y 17.327 acciones subyacentes) con precio de ejercicio de $0.3663, ejercitables hasta el 31/10/2031 y el 22/03/2032; los recuentos de acciones y el precio de ejercicio reflejan una consolidación inversa 1 a 3,33 vinculada a la OPI del emisor. Una opción está totalmente consolidada y la otra parcialmente. El Formulario 4 se presentó con retraso por un error administrativo.

CapsoVision, Inc.의 보고자 Rebecca Ann Petersen이 보통주 24,834주를 취득했으며, 최근 역병합으로 조정된 주식옵션을 보유하고 있습니다. Form 4에는 2025-08-18에 주당 $0.3663에 24,834주를 매수해 직접 실질보유 주식이 24,834주가 되었다고 기재되어 있습니다. 제출서류는 또한 행사가 $0.3663인 두 건의 옵션 부여(기초주식 7,507주 및 17,327주)에 대해 보고하며, 이 옵션들은 2031-10-31 및 2032-03-22까지 행사할 수 있습니다. 옵션의 주식 수와 행사가격은 발행사의 IPO와 관련된 1대3.33 역병합을 반영합니다. 한 옵션은 완전히 베스티드되었고 다른 하나는 부분적으로 베스티드되었습니다. Form 4는 행정적 오류로 인해 지연 제출되었습니다.

Rebecca Ann Petersen, personne déclarante de CapsoVision, Inc., a acquis 24 834 actions ordinaires et détient des options sur actions ajustées suite à une division inverse. Le formulaire 4 indique l'achat de 24 834 actions au prix de 0,3663 $ par action le 18/08/2025, portant la détention directe bénéficiaire à 24 834 actions. Le dossier signale également deux attributions d'options (7 507 et 17 327 actions sous-jacentes) avec un prix d'exercice de 0,3663 $, exerçables jusqu'au 31/10/2031 et au 22/03/2032 ; les nombres d'actions des options et le prix d'exercice reflètent un regroupement d'actions inverse de 1 pour 3,33 lié à l'IPO de l'émetteur. Une option est entièrement acquise, l'autre est partiellement acquise. Le formulaire 4 a été déposé en retard en raison d'une erreur administrative.

Rebecca Ann Petersen, meldepflichtige Person von CapsoVision, Inc., erwarb 24.834 Stammaktien und hält Aktienoptionen, die nach einem kürzlichen Reverse-Split angepasst wurden. Das Formular 4 weist einen Kauf von 24.834 Aktien zum Preis von $0.3663 je Aktie am 18.08.2025 aus, wodurch sich der direkte wirtschaftliche Besitz auf 24.834 Aktien beläuft. Die Meldung berichtet außerdem über zwei Optionszuteilungen (7.507 bzw. 17.327 zugrundeliegende Aktien) mit einem Ausübungspreis von $0.3663, ausübbar bis zum 31.10.2031 bzw. 22.03.2032; die Optionsstückzahlen und der Ausübungspreis spiegeln einen 1-für-3,33 Reverse-Split im Zusammenhang mit dem IPO des Emittenten wider. Eine Option ist vollständig vestiert, die andere teilweise. Das Formular 4 wurde aufgrund eines administrativen Fehlers verspätet eingereicht.

Positive
  • Direct acquisition of 24,834 shares at $0.3663, increasing the reporting person’s direct ownership
  • Restated options reflect the 1-for-3.33 reverse split, preserving prior economic terms and clarifying post-split holdings
  • One option fully vested, providing immediate exercisability for that tranche
Negative
  • Late Form 4 filing reported as due to an administrative error, which raises compliance and disclosure concerns

Insights

TL;DR: Insider purchased common shares and holds adjusted options after a reverse split; transactions are routine but noteworthy for ownership changes.

The reported acquisition of 24,834 shares at $0.3663 is a direct purchase that increases the reporting person’s stake at a modest price per share. The options reported (7,507 and 17,327 underlying shares) have exercise prices and share counts restated to reflect a 1-for-3.33 reverse split, preserving prior economic terms while changing nominal amounts. One option is fully vested, supporting immediate exercisability for that tranche, while the other remains partially vested. These items change insider alignment with equity but do not on their face indicate material corporate developments.

TL;DR: Transactions are standard insider activity, but the late filing raises governance and compliance concerns.

The substance of the Form 4—an insider purchase and option holdings adjusted for a reverse split—is routine. However, the report discloses the Form 4 was filed late due to an administrative error. Timely Section 16 reporting is a compliance expectation; late reporting can reduce transparency for investors and may warrant internal process review. The reverse-split adjustments are documented, which helps maintain clarity on post-split economics.

Rebecca Ann Petersen, reporting person di CapsoVision, Inc., ha acquistato 24.834 azioni ordinarie e detiene opzioni su azioni rettificate in seguito a un raggruppamento azionario inverso. Il Form 4 riporta l'acquisto di 24.834 azioni al prezzo di $0.3663 per azione il 18/08/2025, portando il totale delle azioni detenute direttamente a 24.834. La comunicazione segnala inoltre due concessioni di opzioni (sottostanti 7.507 e 17.327 azioni) con prezzo di esercizio di $0.3663, esercitabili fino al 31/10/2031 e al 22/03/2032; i conteggi delle azioni delle opzioni e il prezzo di esercizio riflettono un raggruppamento azionario inverso 1-per-3,33 collegato all'IPO dell'emittente. Un'opzione è totalmente maturata, l'altra è parzialmente maturata. Il Form 4 è stato depositato in ritardo a causa di un errore amministrativo.

Rebecca Ann Petersen, persona informante de CapsoVision, Inc., adquirió 24.834 acciones ordinarias y posee opciones sobre acciones ajustadas por una consolidación inversa. El Formulario 4 muestra la compra de 24.834 acciones a $0.3663 por acción el 18/08/2025, resultando en 24.834 acciones poseídas de forma directa. La presentación también informa de dos adjudicaciones de opciones (7.507 y 17.327 acciones subyacentes) con precio de ejercicio de $0.3663, ejercitables hasta el 31/10/2031 y el 22/03/2032; los recuentos de acciones y el precio de ejercicio reflejan una consolidación inversa 1 a 3,33 vinculada a la OPI del emisor. Una opción está totalmente consolidada y la otra parcialmente. El Formulario 4 se presentó con retraso por un error administrativo.

CapsoVision, Inc.의 보고자 Rebecca Ann Petersen이 보통주 24,834주를 취득했으며, 최근 역병합으로 조정된 주식옵션을 보유하고 있습니다. Form 4에는 2025-08-18에 주당 $0.3663에 24,834주를 매수해 직접 실질보유 주식이 24,834주가 되었다고 기재되어 있습니다. 제출서류는 또한 행사가 $0.3663인 두 건의 옵션 부여(기초주식 7,507주 및 17,327주)에 대해 보고하며, 이 옵션들은 2031-10-31 및 2032-03-22까지 행사할 수 있습니다. 옵션의 주식 수와 행사가격은 발행사의 IPO와 관련된 1대3.33 역병합을 반영합니다. 한 옵션은 완전히 베스티드되었고 다른 하나는 부분적으로 베스티드되었습니다. Form 4는 행정적 오류로 인해 지연 제출되었습니다.

Rebecca Ann Petersen, personne déclarante de CapsoVision, Inc., a acquis 24 834 actions ordinaires et détient des options sur actions ajustées suite à une division inverse. Le formulaire 4 indique l'achat de 24 834 actions au prix de 0,3663 $ par action le 18/08/2025, portant la détention directe bénéficiaire à 24 834 actions. Le dossier signale également deux attributions d'options (7 507 et 17 327 actions sous-jacentes) avec un prix d'exercice de 0,3663 $, exerçables jusqu'au 31/10/2031 et au 22/03/2032 ; les nombres d'actions des options et le prix d'exercice reflètent un regroupement d'actions inverse de 1 pour 3,33 lié à l'IPO de l'émetteur. Une option est entièrement acquise, l'autre est partiellement acquise. Le formulaire 4 a été déposé en retard en raison d'une erreur administrative.

Rebecca Ann Petersen, meldepflichtige Person von CapsoVision, Inc., erwarb 24.834 Stammaktien und hält Aktienoptionen, die nach einem kürzlichen Reverse-Split angepasst wurden. Das Formular 4 weist einen Kauf von 24.834 Aktien zum Preis von $0.3663 je Aktie am 18.08.2025 aus, wodurch sich der direkte wirtschaftliche Besitz auf 24.834 Aktien beläuft. Die Meldung berichtet außerdem über zwei Optionszuteilungen (7.507 bzw. 17.327 zugrundeliegende Aktien) mit einem Ausübungspreis von $0.3663, ausübbar bis zum 31.10.2031 bzw. 22.03.2032; die Optionsstückzahlen und der Ausübungspreis spiegeln einen 1-für-3,33 Reverse-Split im Zusammenhang mit dem IPO des Emittenten wider. Eine Option ist vollständig vestiert, die andere teilweise. Das Formular 4 wurde aufgrund eines administrativen Fehlers verspätet eingereicht.

SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
OMB APPROVAL
OMB Number: 3235-0287
Estimated average burden
hours per response: 0.5
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan for the purchase or sale of equity securities of the issuer that is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10.
1. Name and Address of Reporting Person*
Petersen Rebecca Ann

(Last) (First) (Middle)
C/O CAPSOVISION, INC.
18805 COX AVENUE, SUITE 250

(Street)
SARATOGA CA 95070

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
CapsoVision, Inc [ CV ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Director of Clinical Affairs
3. Date of Earliest Transaction (Month/Day/Year)
08/18/2025
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 08/18/2025 M 24,834 A $0.3663 24,834 D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Stock Option (right to buy) $0.3663(1) 08/18/2025 M 7,507 (2) 10/31/2031 Common Stock 7,507(3) $0 0(3) D
Stock Option (right to buy) $0.3663(1) 08/18/2025 M 17,327 (4) 03/22/2032 Common Stock 17,327(3) $0 3,694(3) D
Explanation of Responses:
1. 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.
2. The option was granted on October 28, 2021 and is fully vested and exercisable as of the transaction date.
3. 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.
4. The option was granted on March 23, 2022 and is partially vested and exercisable as of the transaction date.
Remarks:
The Form 4 is being filed late due to an inadvertent administrative error.
/s/ Tai Vivatvaraphol, Attorney-in-Fact for Rebecca Petersen 08/22/2025
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.

FAQ

What transactions did Rebecca Ann Petersen report for CapsoVision (CV)?

The Form 4 reports a purchase of 24,834 common shares at $0.3663 on 08/18/2025 and two stock options covering 7,507 and 17,327 underlying shares adjusted for a reverse split.

How did the 1-for-3.33 reverse split affect the reported options?

The filing states the exercise price and share counts were restated to reflect the 1-for-3.33 reverse stock split effected on July 2, 2025, changing nominal amounts while preserving economic terms.

Are any of the reported options exercisable immediately?

Yes. The option covering 7,507 underlying shares (granted October 28, 2021) is reported as fully vested and exercisable on the transaction date; the other option is partially vested.

Was the Form 4 filed on time?

No. The Form 4 includes a remark that it was filed late due to an inadvertent administrative error.

What are the expiration dates for the reported options?

The filing lists expiration dates of 10/31/2031 for the 7,507-share option and 03/22/2032 for the 17,327-share option.
CapsoVision, Inc.

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