X0508 4 2024-07-03 0001844505 QT IMAGING HOLDINGS, INC. QTI 0000939568 KLOCK JOHN C JR QT IMAGING HOLDINGS, INC. 3 HAMILTON LANDING SUITE 160 NOVATO CA 94949 1 0 1 0 0 Common Stock 2881140 I By John C. Klock, Jr. and Cynthia L. Klock Trust Dated 7/27/07 Stock Option (right to buy) 0.748 2024-07-03 4 A 0 40000 0 A 2034-07-03 Common Stock 40000 40000 D The Common Stock are held directly by John C. Klock, Jr. and Cynthia L. Klock Trust Dated 7/27/07 (the "Trust"). The Common Stock held by the Trust are beneficially owned jointly by Dr. John C. Klock, Jr., the Issuer's Director and Cynthia L. Klock, wife of Dr. John C. Klock, Jr., who jointly have sole voting and dispositive power over the shares held by the Trust. One-third of the option will vest on February 15, 2025, and the remaining two thirds will vest in eight equal quarterly installments on each subsequent May 15, August 15, November 15 and February 15, such that the option will be fully vested on February 15, 2027, subject to the Reporting Person's continued service to the Issuer, through each vesting date. /s/ John C. Klock, Jr. 2024-07-10