Sec Form 4 Filing - MIDDLETON FRED A @ CalciMedica, Inc. - 2023-05-19

Insider filing report for Changes in Beneficial Ownership
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FORM 4
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
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, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
MIDDLETON FRED A
2. Issuer Name and Ticker or Trading Symbol
CalciMedica, Inc. [ CALC]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X __ Director X __ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
(Last) (First) (Middle)
C/O CALCIMEDICA, INC., 505 COAST S. BLVD. #202
3. Date of Earliest Transaction (MM/DD/YY)
05/19/2023
(Street)
LA JOLLA, CA92037
4. If Amendment, Date Original Filed (MM/DD/YY)
6. Individual or Joint/Group Filing (Check Applicable Line)
__ X __ Form filed by One Reporting Person
_____ Form filed by More than One Reporting Person
(City) (State) (Zip)
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Transaction Date (MM/DD/YY) 2A. Deemed Execution Date, if any (MM/DD/YY) 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 05/19/2023 P 10,000 A $ 2.85 10,000 D
Common Stock 703,388 I By Sanderling Venture Partners VI, L.P. ( 1 )
Common Stock 582,757 I By Sanderling Venture Partners VI Co-Investment Fund, L.P. ( 1 )
Common Stock 17,682 I By Sanderling Ventures Management VI ( 1 )
Common Stock 7,456 I By Sanderling VI Beteligungs GmbH & Co KG ( 1 )
Common Stock 8,884 I By Sanderling VI Limited Partnership ( 1 )
Common Stock 240,676 I By Sanderling Ventures VII, L.P. ( 2 )
Common Stock 14,425 I By Sanderling Ventures VII Annex Fund, L.P. ( 2 )
Common Stock 63,228 I By Sanderling Ventures VII (Canada), L.P. ( 2 )
Common Stock 1,548 I By Sanderling Ventures Management VII ( 2 )
Common Stock 8,176 I By Golden Triangle Ventures, LLC ( 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 (MM/DD/YY) 3A. Deemed Execution Date, if any (MM/DD/YY) 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
(MM/DD/YY)
7. Title and Amount of Underlying Securities
(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 of Derivative Security: 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
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
MIDDLETON FRED A
C/O CALCIMEDICA, INC.
505 COAST S. BLVD. #202
LA JOLLA, CA92037
X X
Signatures
By John Dunn, Attorney-in-Fact 05/22/2023
Signature of Reporting Person Date
Explanation of Responses:
( 1 )The Reporting Person, a director of Sanderling Ventures, may be deemed to beneficially own the securities of the Issuer held by Sanderling Venture Partners VI, LP, Sanderling Venture Partners VI Co-Investment Fund, LP, Sanderling VI Beteiligungs GmbH & Co. KG, Sanderling Ventures Management VI and Sanderling VI Limited Partnership (together, the "Sanderling VI Securities"). The Reporting Person disclaims beneficial ownership of the Sanderling VI Securities except to the extent of his pecuniary interest therein.
( 2 )The Reporting Person, a director of Sanderling Ventures, may be deemed to beneficially own the securities of the Issuer held by Sanderling Ventures VII, LP, Sanderling Ventures Management VII, Sanderling Ventures VII (Canada), LP and Sanderling Ventures VII Annex Fund, L.P. (together, the "Sanderling VII Securities"). The Reporting Person disclaims beneficial ownership of the Sanderling VII Securities except to the extent of his pecuniary interest therein.
( 3 )The Reporting Person is a managing member of Golden Triangle Ventures LLC and may be deemed to beneficially own the securities of the Issuer held by Golden Triangle Ventures LLC. The Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein.

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).
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