SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
Modersitzki Blake G

(Last) (First) (Middle)
2750 E. COTTONWOOD PARK
SUITE 600

(Street)
SALT LAKE CITY UT 84121

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
Weave Communications, Inc. [ WEAV ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
05/26/2022
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 05/26/2022 A 30,358(1) A $0.00 67,358 D
Common Stock 4,535,789 I By Pelion Ventures VI, L.P.(2)
Common Stock 310,138 I By Pelion Ventures VI-A, L.P.(2)
Common Stock 530,529 I By Pelion Ventures VII, L.P.(3)
Common Stock 109,323 I By Pelion Ventures VII-A, L.P.(3)
Common Stock 59,592 I By Pelion Ventures VII-Entrepreneurs Fund, L.P.(3)
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Explanation of Responses:
1. Represents 30,358 restricted stock units (the "RSUs") granted to the Reporting Person as a director of the Issuer. Each restricted stock unit represents the right to receive one share of the Issuer's Common Stock upon vesting. The RSUs will vest in full on the earlier of (i) May 26, 2023 and (ii) the date of the first annual meeting of the Issuer's stockholders following May 26, 2022. Such grant is exempt from Section 16(b) of the Securities Exchange Act of 1934, as amended, in reliance on Rule 16b-3(d).
2. Pelion Venture Partners VI, L.L.C. ("PVP VI") is the sole general partner of Pelion Ventures VI, L.P. ("PV VI") and Pelion Ventures VI-A, L.P. ("PV VI-A"). The Reporting Person is the managing director of PVP VI and PV VI-A and may be deemed to exercise voting and dispositive power over the shares held by PV VI and PV VI-A. The Reporting Person disclaims beneficial ownership of the shares held by PV VI and PV VI-A except to the extent of his pecuniary interest therein.
3. Pelion Venture Partners VII, L.L.C. ("PVP VII") is the sole general partner of Pelion Ventures VII, L.P. ("PV VII"), Pelion Ventures VII-A, L.P. ("PV VII-A") and Pelion Ventures VII-Entrepreneurs Fund, L.P. ("PV VII-Entrepreneurs") . The Reporting Person is a managing director of PVP VII, PV VII-A and PV VII-Entrepreneurs and may be deemed to share voting and dispositive power over the shares held by PVP VII, PV VII-A and PV VII-Entrepreneurs. The Reporting Person disclaims beneficial ownership of the shares held by PVP VII, PV VII-A and PV VII-Entrepreneurs except to the extent of his pecuniary interest therein.
Remarks:
/s/ Erin Goodsell, as Attorney-in-Fact 03/08/2023
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.