SEC Form 4 · accession 0001213900-26-097490
Profusa, Inc. · PFSA
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Jack E Stover
Officer — Chief Executive Officer
Period of report
Aug 21, 2026
Accepted (ET)
Sep 4, 2026 · 10:47 am EDT
Rule 10b5-1 plan
box not checked
Issuer CIK
0001859807
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1,F2 | Aug 21, 2026 | J | 32,018 | $0.00 | A | 32,091 | D | |
| Common StockF3,F4 | Aug 21, 2026 | J | 301,991 | $0.00 | D | 0 | I | By NorthView Sponsor I LLC |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1Pro rata distribution from NorthView Sponsor I LLC, of which the reporting person is a manager.
- F2Includes 73 shares held directly by the reporting person.
- F3On August 21, 2026, NorthView Sponsor I LLC distributed all its shares of Issuer's common stock to its members, including 32,018 shares to the reporting person.
- F4Jack Stover is a manager of NorthView Sponsor I LLC and may be deemed to share beneficial ownership of the securities held by NorthView Sponsor I LLC. Mr. Stover disclaims beneficial ownership of such securities except to the extent of his pecuniary interest therein.