Jennifer Ernst - 18 Dec 2025 Form 4 Insider Report for Tivic Health Systems, Inc. (TIVC)

Role
Chief Executive Officer, Director
Signature
/s/ Jennifer Ernst
Issuer symbol
TIVC
Transactions as of
18 Dec 2025
Net transactions value
-$9,840
Form type
4
Filing time
22 Dec 2025, 20:44:46 UTC
Previous filing
24 Sep 2025
SEC
View on sec.gov

Reporting Owners (1)

Name Relationship Address Signature Signature date CIK
Ernst Jennifer Chief Executive Officer, Director 47685 LAKEVIEW BOULEVARD, FREMONT /s/ Jennifer Ernst 22 Dec 2025 0001889915

Transactions Table

Type Sym Class Transaction Value $ Shares Change % * Price $ Shares After Date Ownership Footnotes
transaction TIVC Common Stock Options Exercise +14,706 +63% 37,953 18 Dec 2025 Direct F1
transaction TIVC Common Stock Tax liability $9,840 -5,262 -14% $1.87 32,691 18 Dec 2025 Direct F2

Derivative Securities (e.g., puts, calls, warrants, options, convertible securities)

Type Sym Class Transaction Value $ Shares Change % * Price $ Shares After Date Underlying Class Amount Exercise Price Ownership Footnotes
transaction TIVC Restricted Stock Units Options Exercise $0 -14,706 -50% $0.000000 14,706 18 Dec 2025 Common Stock 14,706 Direct F1, F3
* An asterisk sign (*) next to the price indicates that the price is likely invalid.

Explanation of Responses:

Id Content
F1 Each Restricted Stock Unit is convertible into one share of Common Stock.
F2 The Reporting Person forfeited 5,262 shares of Common Stock upon vesting and settlement of 14,706 outstanding Restricted Stock Units to cover tax withholdings, using the market price of the Issuer's common stock at the time of forfeiture.
F3 Fifty percent (50%) of the Restricted Stock Units will vest upon the one (1) year anniversary of the date of grant, December 18, 2024 (the "Vesting Commencement Date"), and the balance of the Restricted Stock Units will be vested in a series of eight (8) successive equal quarterly installments measured from the first anniversary of the Vesting Commencement Date such that one hundred percent (100%) of the Restricted Stock Units shall have vested on the third anniversary of the Vesting Commencement Date.