SEC Form 4 · accession 0001193125-26-288996
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,F9 | May 11, 2026 | C | 11,139 | — | A | 11,139 | I | See Footnote |
| Common StockF1,F3,F9 | May 11, 2026 | C | 29,704 | — | A | 29,704 | I | See Footnote |
| Common StockF1,F3,F9 | May 11, 2026 | C | 21,819 | — | A | 51,523 | I | See Footnote |
| Common StockF4,F3,F9 | May 11, 2026 | C | 10,000 | — | A | 61,523 | I | See Footnote |
| Common StockF1,F5,F9 | May 11, 2026 | C | 22,278 | — | A | 22,278 | I | See Footnote |
| Common StockF1,F5,F9 | May 11, 2026 | C | 10,909 | — | A | 33,187 | I | See Footnote |
| Common StockF4,F5,F9 | May 11, 2026 | C | 8,500 | — | A | 41,687 | I | See Footnote |
| Common StockF1,F6,F9 | May 11, 2026 | C | 141,054 | — | A | 141,054 | I | See Footnote |
| Common StockF1,F7,F9 | May 11, 2026 | C | 96,540 | — | A | 96,540 | I | See Footnote |
| Common StockF1,F7,F9 | May 11, 2026 | C | 112,843 | — | A | 209,383 | I | See Footnote |
| Common StockF1,F7,F9 | May 11, 2026 | C | 108,005 | — | A | 317,388 | I | See Footnote |
| Common StockF4,F7,F9 | May 11, 2026 | C | 33,333 | — | A | 350,721 | I | See Footnote |
| Common StockF1,F8,F9 | May 11, 2026 | C | 68,044 | — | A | 68,044 | I | See Footnote |
| Common StockF1,F8,F9 | May 11, 2026 | C | 200,202 | — | A | 268,246 | 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 E-1 Preferred StockF1,F2,F9 | — | May 11, 2026 | C | 38,798 | D | — | — | Common Stock | 11,139 | 0 | I |
| Series E-1 Preferred StockF1,F3,F9 | — | May 11, 2026 | C | 103,461 | D | — | — | Common Stock | 29,704 | 0 | I |
| Series F Preferred StockF1,F3,F9 | — | May 11, 2026 | C | 75,996 | D | — | — | Common Stock | 21,819 | 0 | I |
| Convertible NotesF4,F3,F9 | — | May 11, 2026 | C | 120,000 | D | — | — | Common Stock | 10,000 | 0 | I |
| Series E-1 Preferred StockF1,F5,F9 | — | May 11, 2026 | C | 77,596 | D | — | — | Common Stock | 22,278 | 0 | I |
| Series F Preferred StockF1,F5,F9 | — | May 11, 2026 | C | 37,998 | D | — | — | Common Stock | 10,909 | 0 | I |
| Convertible NotesF4,F5,F9 | — | May 11, 2026 | C | 102,000 | D | — | — | Common Stock | 8,500 | 0 | I |
| Series E-2 Preferred StockF1,F6,F9 | — | May 11, 2026 | C | 491,294 | D | — | — | Common Stock | 141,054 | 0 | I |
| Series E-1 Preferred StockF1,F7,F9 | — | May 11, 2026 | C | 336,251 | D | — | — | Common Stock | 96,540 | 0 | I |
| Series E-2 Preferred StockF1,F7,F9 | — | May 11, 2026 | C | 393,034 | D | — | — | Common Stock | 112,843 | 0 | I |
| Series F Preferred StockF1,F7,F9 | — | May 11, 2026 | C | 376,182 | D | — | — | Common Stock | 108,005 | 0 | I |
| Convertible NotesF4,F7,F9 | — | May 11, 2026 | C | 400,000 | D | — | — | Common Stock | 33,333 | 0 | I |
| Series D Preferred StockF1,F8,F9 | — | May 11, 2026 | C | 237,000 | D | — | — | Common Stock | 68,044 | 0 | I |
| Series E-1 Preferred StockF1,F8,F9 | — | May 11, 2026 | C | 697,305 | D | — | — | Common Stock | 200,202 | 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.
- F2The securities are held by GPG BFH, LLC ("BFH").
- F3The securities are held by GPG Charles & Potomac, LLC ("C&P").
- F4The 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.
- F5The securities are held by GPG Dais, LLC ("Dais").
- F6The securities are held by GPG GR, LLC ("GR").
- F7The securities are held by GPG Healthcare Opportunities Fund II, LLC ("HOF II").
- F8The securities are held by GPG Healthcare Opportunities Fund, LLC ("HOF").
- F9Green Park & Golf Ventures II, LLC ("GPG Ventures II") is the managing member of each of BFH, C&P, Dais, GR, HOF, and HOF II. 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 BFH, C&P, Dais, GR, HOF, and HOF II, and as a result may be deemed to beneficially own such securities.
Remarks
This Form 4 is the first 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.