X0306 4/A 2021-10-26 2021-10-28 0 0001452965 MINERVA SURGICAL INC UTRS 0001181338 JAFFE ROSS A MD C/O MINERVA SURGICAL, INC. 4255 BURTON DRIVE SANTA CLARA CA 95054 1 0 0 0 Common Stock 2021-10-26 4 C 0 94755 A 94755 I See Footnote Subordinated Secured Convertible Promissory Note 11.306 2021-10-26 4 C 0 395813.73 0.00 D Series D Preferred Stock 35009 0 I See Footnote Subordinated Secured Convertible Promissory Note 11.306 2021-10-26 4 C 0 395556.98 0.00 D Series D Preferred Stock 34986 0 I See Footnote Subordinated Secured Convertible Promissory Note 11.306 2021-10-26 4 C 0 279941.92 0.00 D Series D Preferred Stock 24760 0 I See Footnote Series D Preferred Stock 2021-10-26 4 C 0 35009 0.00 A Common Stock 35009 35009 I See Footnote Series D Preferred Stock 2021-10-26 4 C 0 34986 0.00 A Common Stock 34986 69995 I See Footnote Series D Preferred Stock 2021-10-26 4 C 0 24760 0.00 A Common Stock 24760 94755 I See Footnote Series D Preferred Stock 2021-10-26 4 C 0 35009 0.00 D Common Stock 35009 59746 I See Footnote Series D Preferred Stock 2021-10-26 4 C 0 34986 0.00 D Common Stock 34986 24760 I See Footnote Series D Preferred Stock 2021-10-26 4 C 0 24760 0.00 D Common Stock 24760 0 I See Footnote The Series D Preferred Stock automatically converted into Common Stock on a 1:1 basis immediately prior to the completion of the Issuer's initial public offering of Common Stock and had no expiration date. The securities are held by The Jaffe Family Trust dtd 7/9/91 of which Ross A Jaffe is a trustee. Represents $395,813.73 of outstanding principal and interest calculated through October 26, 2021, on which date such amount converted into shares of Series D Preferred Stock at a conversion price per share of $11.30602. Represents $395,556.98 of outstanding principal and interest calculated through October 26, 2021, on which date such amount converted into shares of Series D Preferred Stock at a conversion price per share of $11.30602. Represents $279,941.92 of outstanding principal and interest calculated through October 26, 2021, on which date such amount converted into shares of Series D Preferred Stock at a conversion price per share of $11.30602. 1/2. Since there are more than 30 rows associated with the applicable transactions and EDGAR will not allow for the entry of more than 30 rows on a single Form 4, this Form 4 is being filed in conjunction with a second Form 4 by the Reporting Person. The two Form 4s filed by the Reporting Person on the date hereof should be read together as on consolidated filing. This amended Form 4 is being filed to correct an inadvertent omission from the Form 4 filed on October 28, 2021, as amended on December 8, 2021 (the "Prior Form 4"), which omitted the Series C Preferred Stock and Series D Preferred Stock held by each of Versant Venture Capital IV, L.P. and Versant Side Fund IV, L.P. This amended Form 4 amends and restates in its entirety the transactions reported in the Prior Form 4. Robin Praeger, Attorney-in-fact for Ross A Jaffe MD 2022-02-10