SEC Form 4 · accession 0002037266-26-000005
EBR Systems, Inc. · NONE.
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Bronwyn Evans
Director
Period of report
Jun 29, 2026
Accepted (ET)
Jul 1, 2026 · 5:39 pm EDT
Rule 10b5-1 plan
box not checked
Issuer CIK
0001347123
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1,F2,F3,F4 | Jun 29, 2026 | X | 27,579 | $3.80 | A | 112,737 | I | By Bronwyn Evans and Peter Douglas Gordon |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Subscription Rights (right to buy)F1,F2,F3 | $3.80 | Jun 29, 2026 | X | 27,579 | A | Jun 29, 2026 | Jun 29, 2026 | Common Stock | 27,579 | 27,579 | I |
| Subscription Rights (right to buy)F1,F2,F3 | $3.80 | Jun 29, 2026 | X | 27,579 | D | Jun 29, 2026 | Jun 29, 2026 | Common Stock | 27,579 | 0 | I |
Explanation of responses
- F1Represents shares of the Issuer's common stock underlying 275,790 Chess Depositary Interests ("CDIs"). The CDIs are traded on the Australian Securities Exchange (the "ASX") and are held by CHESS Depository Nominees Pty, Limited, a subsidiary of ASX Limited, the company that operates the ASX.
- F2The CDIs were issued in connection with an entitlement offer or rights offering, pursuant to a Security Purchase Plan on ASX.
- F3The price is reported in Australian dollars.
- F4Represents shares of the Issuer's common stock underlying 1,127,370 CDIs. The CDIs are traded on the ASX and are held by CHESS Depository Nominees Pty, Limited, a subsidiary of ASX Limited, the company that operates the ASX.