X0206 3 2025-07-01 0 0001378325 CapsoVision, Inc CV 0001009165 HARARI ELIYAHOU ET AL 225 CHARCOT SAN JOSE CA 95131 0 0 1 0 Common Stock 280000 D Series D-1 Preferred Stock Common Stock 222222 I By trust. Series D-2 Preferred Stock Common Stock 934588 I By trust. Series E Preferred Stock Common Stock 434782 I By trust. Series F-1 Preferred Stock Common Stock 434783 I By trust. Series F-2 Preferred Stock Common Stock 2000000 I By trust. Series G Preferred Stock Common Stock 740741 I By trust. Series G-1 Preferred Stock Common Stock 1206898 I By trust. Series H Preferred Stock Common Stock 4638377 I By trust. Series H Preferred Stock Common Stock 1724139 I By trust. Series H Preferred Stock Common Stock 1724139 I By trust. Does not reflect a one-for-3.33 reverse stock split, to be effective immediately prior to the closing of the initial public offering of the Issuer. Each share of Series D-1 preferred stock, Series D-2 preferred stock, Series E preferred stock, Series F-1 preferred stock, Series F-2 preferred stock, Series G preferred stock, Series G-1 preferred stock and Series H preferred stock (the Preferred Stock) is convertible on a one-to-one basis into shares of common stock at the election of the holder and has no expiration date. The Preferred Stock will automatically convert into the underlying shares of common stock upon the closing of the initial public offering of the Issuer. The number of underlying shares of common stock reported in Column 3 does not reflect a one-for-3.33 reverse stock split, to be effective immediately prior to the closing of the initial public offering of the Issuer. The securities are held by the Harari Family Trust, for which the Reporting Person, together with his wife, are trustees. The securities are held by Harari 2010 Children Remainder Trust - MHG, for which the Reporting Person, together with his wife, are trustees. The securities are held by Harari 2010 Children Remainder Trust - DAH, for which the Reporting Person, together with his wife, are trustees. /s/ Peter Bergman, Attorney-in-Fact for Eliyahou Harari 2025-07-01