SEC Form 4 · accession 0001193125-26-288985
Mobia Medical, Inc. · MOBI
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1,F2,F10 | May 11, 2026 | C | 18,374 | — | A | 18,374 | I | See Footnote |
| Common StockF1,F2,F10 | May 11, 2026 | C | 116,940 | — | A | 135,314 | I | See Footnote |
| Common StockF1,F2,F10 | May 11, 2026 | C | 56,421 | — | A | 191,735 | I | See Footnote |
| Common StockF3,F2,F10 | May 11, 2026 | C | 41,666 | — | A | 233,401 | I | See Footnote |
| Common StockF1,F4,F10 | May 11, 2026 | C | 477,329 | — | A | 477,329 | I | See Footnote |
| Common StockF1,F4,F10 | May 11, 2026 | C | 45,711 | — | A | 523,040 | I | See Footnote |
| Common StockF3,F4,F10 | May 11, 2026 | C | 32,750 | — | A | 555,790 | I | See Footnote |
| Common StockF1,F5,F10 | May 11, 2026 | C | 282,122 | — | A | 282,122 | I | See Footnote |
| Common StockF1,F6,F10 | May 11, 2026 | C | 60,579 | — | A | 60,579 | I | See Footnote |
| Common StockF7,F6,F10 | May 11, 2026 | X | 9,474 | — | A | 70,053 | I | See Footnote |
| Common StockF1,F8,F10 | May 11, 2026 | C | 24,506 | — | A | 24,506 | I | See Footnote |
| Common StockF1,F9,F10 | May 11, 2026 | C | 43,640 | — | A | 43,640 | I | See Footnote |
| Common StockF7,F9,F10 | May 11, 2026 | X | 6,890 | — | A | 50,530 | I | See Footnote |
| Common StockF7,F9,F10 | May 11, 2026 | S$0 | 6,731 | — | D | 43,799 | I | See Footnote |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Series D Preferred StockF1,F2,F10 | — | May 11, 2026 | C | 64,000 | D | — | — | Common Stock | 18,374 | 0 | I |
| Series E-1 Preferred StockF1,F2,F10 | — | May 11, 2026 | C | 407,304 | D | — | — | Common Stock | 116,940 | 0 | I |
| Series E-2 Preferred StockF1,F2,F10 | — | May 11, 2026 | C | 196,516 | D | — | — | Common Stock | 56,421 | 0 | I |
| Convertible NotesF3,F2,F10 | — | May 11, 2026 | C | 500,000 | D | — | — | Common Stock | 41,666 | 0 | I |
| Series E-2 Preferred StockF1,F4,F10 | — | May 11, 2026 | C | 1,662,538 | D | — | — | Common Stock | 477,329 | 0 | I |
| Series F Preferred StockF1,F4,F10 | — | May 11, 2026 | C | 159,212 | D | — | — | Common Stock | 45,711 | 0 | I |
| Convertible NotesF3,F4,F10 | — | May 11, 2026 | C | 393,000 | D | — | — | Common Stock | 32,750 | 0 | I |
| Series F Preferred StockF1,F5,F10 | — | May 11, 2026 | C | 982,634 | D | — | — | Common Stock | 282,122 | 0 | I |
| Series D Preferred StockF1,F6,F10 | — | May 11, 2026 | C | 211,000 | D | — | — | Common Stock | 60,579 | 0 | I |
| Series D Preferred WarrantF7,F6,F10 | — | May 11, 2026 | X | 33,000 | D | — | — | Common Stock | 9,474 | 0 | I |
| Series E-1 Preferred StockF1,F8,F10 | — | May 11, 2026 | C | 85,356 | D | — | — | Common Stock | 24,506 | 0 | I |
| Series D Preferred StockF1,F9,F10 | — | May 11, 2026 | C | 152,000 | D | — | — | Common Stock | 43,640 | 0 | I |
| Series D Preferred WarrantF7,F9,F10 | — | May 11, 2026 | X | 24,000 | D | — | — | Common Stock | 6,890 | 0 | I |
Explanation of responses
- F1Each share of Series D Preferred Stock, Series F Preferred Stock, Series E-1 Preferred Stock and Series E-2 Preferred Stock converted into Common Stock immediately prior to the completion of the Issuer's initial public offering (the "Offering") pursuant to its terms.
- F10Green Park & Golf Ventures II, LLC ("GPG Ventures II") is the managing member of each of JCT, MTI 22, MTI 25, MTI 3-17, PHL, and RM. Clay M. Heighten, MD, Carl D. Soderstrom and Gilbert G. Garcia II are managers of GPG Ventures II and share voting and dispositive power with respect to the shares held by each of JCT, MTI 22, MTI 25, MTI 3-17, PHL, and RM., and as a result may be deemed to beneficially own such securities.
- F11RM paid the exercise price on a cashless basis, resulting in the Issuer's withholding of 6,731 shares of Common Stock to pay the exercise price and issuing to the reporting person the remaining 159 shares of Common Stock.
- F2The securities are held by GPG JCT, LLC ("JCT").
- F3The Convertible Notes automatically converted into Common Stock immediately prior to the closing of the Offering. The conversion price is the lower of (a) 80% of the Offering price per share and (b) the valuation of the Issuer immediately prior to the closing of the Offering divided by the number of fully diluted shares of capital stock (on an as-converted basis) outstanding immediately prior to Offering, excluding the Convertible Notes.
- F4The securities are held by GPG MTI 22, LLC ("MTI 22").
- F5The securities are held by GPG MTI 25, LLC ("MTI 25").
- F6The securities are held by GPG MTI 3-17 Investment, LLC ("MTI 3-17").
- F7Common stock issued upon exercise of warrant to purchase Series D Preferred Stock. The warrants are currently exercisable and have an exercise price of $4.207 per share. Unless exercised earlier, the warrants will expire on May 25, 2033.
- F8The securities are held by GPG PHL, LLC ("PHL").
- F9The securities are held by GPG RM Investment, LLC ("RM").
Remarks
This Form 4 is the second of five Forms 4 filed relating to the same event. Combined, the five Forms 4 report the holdings for the following reporting persons: Green Park & Golf Ventures II, LLC, Clay M. Heighten, MD, Carl D. Soderstrom, Gilbert G. Garcia II, GPG BFH, LLC, GPG Charles & Potomac, LLC, GPG Dais, LLC, GPG GR, LLC, GPG Healthcare Opportunities Fund II, LLC, GPG Healthcare Opportunities Fund, LLC, GPG JCT, LLC, GPG MTI 22, LLC, GPG MTI 25, LLC, GPG MOBI, LLC, GPG MTI 3-17 Investment, LLC, GPG PHL, LLC, GPG RM Investment, LLC, GPG SC, LLC, GPG WG, LLC, GPG MTIF, LLC, Micro TI Investment 2, LLC, Micro TI Investment, LLC, MTI 20 Investment, LLC, MTI 2015 Investment, LLC, HTX MCT1 0320 Investment, LLC, HTX MCT2 0221 Investment, LLC, HTX MCT3 0322 Investment, LLC, HTX MCT4 0226 Investment, LLC and Green Park & Golf Ventures - Houston, LLC. The Form 4 has been split into five filings because there are more than 10 reporting persons in total, and the SEC's EDGAR filing system limits a single Form 4 to a maximum of 10 reporting persons.