# EDGAR Filing Document

**Accession Number:** 0001734820
**File Stem:** 0001415889-25-020133
**Filing Date:** 2025-7
**Character Count:** 14659
**Document Hash:** 5f395e6c5c847676a30d802fdbc1ecb0
**Contains OCR:** False
**Source Format:** 

## Filing Content

## Filing Summary
**0001415889-25-020133.hdr.sgml**: 20250722

**ACCESSION NUMBER**: 0001415889-25-020133

**CONFORMED SUBMISSION TYPE**: 3

**PUBLIC DOCUMENT COUNT**: 2

**CONFORMED PERIOD OF REPORT**: 20250722

**FILED AS OF DATE**: 20250722

**DATE AS OF CHANGE**: 20250722

**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** Tansey Casey M
- **CENTRAL INDEX KEY:** 0001474322

**ORGANIZATION NAME:**

**FILING VALUES:**
- **FORM TYPE:** 3
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-42756
- **FILM NUMBER:** 251141256

**MAIL ADDRESS:**
- **STREET 1:** 1460 EL CAMINO REAL STE 100
- **CITY:** MENLO PARK
- **STATE:** CA
- **ZIP:** 94025
**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** U.S. Venture Partners XII, L.P.
- **CENTRAL INDEX KEY:** 0001734819

**ORGANIZATION NAME:**
- **STATE OF INCORPORATION:** DE
- **FISCAL YEAR END:** 1231

**FILING VALUES:**
- **FORM TYPE:** 3
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-42756
- **FILM NUMBER:** 251141257

**BUSINESS ADDRESS:**
- **STREET 1:** 1460 EL CAMINO REAL, SUITE 100
- **CITY:** MENLO PARK
- **STATE:** CA
- **ZIP:** 94025
- **BUSINESS PHONE:** (650) 854-9080

**MAIL ADDRESS:**
- **STREET 1:** 1460 EL CAMINO REAL, SUITE 100
- **CITY:** MENLO PARK
- **STATE:** CA
- **ZIP:** 94025
**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** Presidio Management Group XII, L.L.C.
- **CENTRAL INDEX KEY:** 0001734820

**ORGANIZATION NAME:**
- **STATE OF INCORPORATION:** DE
- **FISCAL YEAR END:** 1231

**FILING VALUES:**
- **FORM TYPE:** 3
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-42756
- **FILM NUMBER:** 251141258

**BUSINESS ADDRESS:**
- **STREET 1:** 1460 EL CAMINO REAL, SUITE 100
- **CITY:** MENLO PARK
- **STATE:** CA
- **ZIP:** 94025
- **BUSINESS PHONE:** (650) 854-9080

**MAIL ADDRESS:**
- **STREET 1:** 1460 EL CAMINO REAL, SUITE 100
- **CITY:** MENLO PARK
- **STATE:** CA
- **ZIP:** 94025
**ISSUER**: 

**COMPANY DATA:**
- **COMPANY CONFORMED NAME:** CARLSMED, INC.
- **CENTRAL INDEX KEY:** 0001794546
- **STANDARD INDUSTRIAL CLASSIFICATION:** SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841]
- **ORGANIZATION NAME:** 08 Industrial Applications and Services
- **EIN:** 831081863
- **STATE OF INCORPORATION:** DE
- **FISCAL YEAR END:** 1231

**BUSINESS ADDRESS:**
- **STREET 1:** 1800 ASTON AVENUE
- **STREET 2:** SUITE 100
- **CITY:** CARLSBAD
- **STATE:** CA
- **ZIP:** 92008
- **BUSINESS PHONE:** 858-295-9290

**MAIL ADDRESS:**
- **STREET 1:** 1800 ASTON AVENUE
- **STREET 2:** SUITE 100
- **CITY:** CARLSBAD
- **STATE:** CA
- **ZIP:** 92008

## Ex-24

**POWER OF ATTORNEY** 

**KNOW ALL MEN BY THESE PRESENTS**, that each of the undersigned hereby constitutes and appoints **DALE HOLLADAY** his or its true and lawful attorney-in-fact (the "***Attorney-in-Fact***") to:

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(1) execute for and on behalf of each undersigned (a "***Reporting Person***") any and all reports, notices, communications and other documents (including, but not limited to, reports on Schedule 13D, Schedule 13G, Form 13H, Form 13-F, Form 3, Form 4 and Form 5) that such Reporting Person may be required to file with the United States Securities and Exchange Commission pursuant to the Securities Act of 1933, as amended, and the Securities Exchange Act of 1934, as amended (collectively, the "***Reports***") with respect to each Reporting Person's (a) status as an officer or director of, or (b) ownership of, or transactions in, securities of, any entity whose securities are beneficially owned (directly or indirectly) by such Reporting Person (each, a "***Company***");

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(2) do and perform any and all acts for and on behalf of each Reporting Person which may be necessary or desirable to complete and execute **any such Reports and timely file such forms and schedules with the United States Securities and Exchange Commission and any stock exchange or similar authority or the Form ADV; and**

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(3) take any other action of any type whatsoever in connection with the foregoing which, in the opinion of either such attorney-in-fact, may be of benefit to, in the best interest of, or legally required by, the undersigned, it being understood that the documents executed by either such attorney-in-fact on behalf of the undersigned, pursuant to this Power of Attorney, shall be in such form and shall contain such terms and conditions as such attorneyin-fact may approve in his discretion.

The undersigned hereby grants to the Attorney-in-Fact full power and authority to do and perform all and every act and thing whatsoever requisite, necessary, and proper to be done in the exercise of any of the rights and powers herein granted, as fully to all intents and purposes as the undersigned might or could do if personally present, with full power of substitution or revocation, hereby ratifying and confirming all that such attorney-in-fact, or his substitute or substitutes, shall lawfully do or cause to be done by virtue of this Power of Attorney and the rights and powers herein granted. The undersigned acknowledges that no such attorneyin-fact, in serving in such capacity at the request of the undersigned, is hereby assuming, nor is the Company hereby assuming, any of the undersigned's responsibilities to comply with Section 16 or Section 13 of the Securities Exchange Act of 1934.

Each Reporting Person hereby further authorizes and designates each of Casey M. Tansey and Kenji Yanagishita (each, an "***Authorized Signatory***") to execute and file on behalf of such Reporting Person the Reports and to perform any and all other acts, which in the opinion of the Attorney-in-Fact or Authorized Signatory may be necessary or incidental to the performance of the foregoing powers herein granted.

This Power of Attorney shall remain in full force and effect until the undersigned is no longer required to file Forms 3, 4 and 5 or Schedules 13G/D with respect to the undersigned's

GDSVF&H\7980340.2

------

holdings of and transactions in securities issued by the Company, unless earlier revoked by the undersigned in a signed writing delivered to the Attorney-in-Fact**. Each Reporting Person acknowledges that the** Attorney-in-F**act, in serving in such capacity at the request of the undersigned, is not hereby assuming any of the undersigned's responsibilities to comply with state or federal securities laws.**

Date: May 9, 2025

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;PRESIDIO MANAGEMENT GROUP XII, L.L.C.<br>By: <u>//Casey M. Tansey</u><br> Name: Casey M. Tansey<br> Title: Managing Member<br>U.S. VENTURE PARTNERS XII, L.P.<br> By Presidio Management Group XII, L.L.C<br> Its General Partner<br>By: <u>//Casey M. Tansey</u><br> Name: Casey M. Tansey<br> Title: Managing Member<br><u>//Casey M. Tansey</u><br> CASEY M. TANSEY<br>

### UNITED STATES SECURITIES AND EXCHANGE COMMISSION
**Washington, D.C. 20549**

## FORM 3

### INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

[ ] 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**<sup>*</sup><br>Presidio Management Group XII, L.L.C.<br><sub>(Last) (First) (Middle)</sub><br>C/O U.S. VENTURE PARTNERS<br>1460 EL CAMINO REAL, SUITE 100<br><sub>(Street)</sub><br>MENLO PARK, CA 94025<br><sub>(City) (State) (Zip)</sub> | **3. Issuer Name and Ticker or Trading Symbol**<br>CARLSMED, INC. [ CARL ] | **5. If Amendment, Date of Original Filed (Month/Day/Year)**<br>  |
| **2. Date of Event Requiring Statement (Month/Day/Year)**<br>2025-07-22 | **4. Relationship of Reporting Person(s) to Issuer**<br>(Check all applicable)<br>[ ] Director   [X] 10% Owner<br>[ ] Officer (give title below)   [ ] Other (specify below)<br>_ _ | **6. Individual or Joint/Group Filing (Check Applicable Line)**<br>[ ] Form filed by One Reporting Person<br>[X] Form filed by More than One Reporting Person |

---

---

| | | |
|:---|:---|:---|
| **1. Name and Address of Reporting Person**<sup>*</sup><br>U.S. Venture Partners XII, L.P.<br><sub>(Last) (First) (Middle)</sub><br>1460 EL CAMINO REAL, SUITE 100<br><sub>(Street)</sub><br>MENLO PARK, CA 94025<br><sub>(City) (State) (Zip)</sub> | **3. Issuer Name and Ticker or Trading Symbol**<br>CARLSMED, INC. [ CARL ] | **5. If Amendment, Date of Original Filed (Month/Day/Year)**<br>  |
| **2. Date of Event Requiring Statement (Month/Day/Year)**<br>2025-07-22 | **4. Relationship of Reporting Person(s) to Issuer**<br>(Check all applicable)<br>[ ] Director   [X] 10% Owner<br>[ ] Officer (give title below)   [ ] Other (specify below)<br>_ _ | **6. Individual or Joint/Group Filing (Check Applicable Line)**<br>[ ] Form filed by One Reporting Person<br>[X] Form filed by More than One Reporting Person |

---

---

| | | |
|:---|:---|:---|
| **1. Name and Address of Reporting Person**<sup>*</sup><br>Tansey Casey M<br><sub>(Last) (First) (Middle)</sub><br>1460 EL CAMINO REAL, SUITE 100<br><sub>(Street)</sub><br>MENLO PARK, CA 94025<br><sub>(City) (State) (Zip)</sub> | **3. Issuer Name and Ticker or Trading Symbol**<br>CARLSMED, INC. [ CARL ] | **5. If Amendment, Date of Original Filed (Month/Day/Year)**<br>  |
| **2. Date of Event Requiring Statement (Month/Day/Year)**<br>2025-07-22 | **4. Relationship of Reporting Person(s) to Issuer**<br>(Check all applicable)<br>[ ] Director   [X] 10% Owner<br>[ ] Officer (give title below)   [ ] Other (specify below)<br>_ _ | **6. Individual or Joint/Group Filing (Check Applicable Line)**<br>[ ] Form filed by One Reporting Person<br>[X] Form filed by More than One Reporting Person |

---

## Table I - Non-Derivative Securities Beneficially Owned

---

|  |  |  |  |
| --- | --- | --- | --- |
| 1. Title of Security | 2. Amount of Securities Beneficially Owned | 3. Ownership Form | 4. Nature of Indirect Beneficial Ownership |

---

## Table II - Derivative Securities Beneficially Owned

---

|  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Derivative Security | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Underlying Securities | 3. Title and Amount of Underlying Securities | 4. Conversion or Exercise Price | 5. Ownership Form | 6. Nature of Indirect Beneficial Ownership |
| 1. Title of Derivative Security | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | 4. Conversion or Exercise Price | 5. Ownership Form | 6. Nature of Indirect Beneficial Ownership |
| Series A Preferred Stock | <sup>(1)</sup> | <sup>(1)</sup> | Common Stock | 2948794 | <sup>(1)</sup> | I | See footnotes<sup>(2)(3)(4)</sup> |
| Series B Preferred Stock | <sup>(1)</sup> | <sup>(1)</sup> | Common Stock | 825135 | <sup>(1)</sup> | I | See footnotes<sup>(2)(3)(4)</sup> |
| Series C Preferred Stock | <sup>(1)</sup> | <sup>(1)</sup> | Common Stock | 531877 | <sup>(1)</sup> | I | See footnotes<sup>(2)(3)(4)</sup> |
| Series A Preferred Stock | <sup>(1)</sup> | <sup>(1)</sup> | Common Stock | 149655 | <sup>(1)</sup> | I | See footnotes<sup>(3)(4)(5)</sup> |
| Series B Preferred Stock | <sup>(1)</sup> | <sup>(1)</sup> | Common Stock | 41876 | <sup>(1)</sup> | I | See footnotes<sup>(3)(4)(5)</sup> |
| Series C Preferred Stock | <sup>(1)</sup> | <sup>(1)</sup> | Common Stock | 26993 | <sup>(1)</sup> | I | See footnotes<sup>(3)(4)(5)</sup> |
| Series C Preferred Stock | <sup>(1)</sup> | <sup>(1)</sup> | Common Stock | 1117743 | <sup>(1)</sup> | I | See footnotes<sup>(3)(4)(6)</sup> |

---

### Footnotes:

(1) These shares of preferred stock are reported after giving effect to the 1-for-5.58 reverse split of the Issuer's common and preferred stock effected on July 10, 2025 (the "Reverse Split"). Each share of Series A Preferred Stock, Series B Preferred Stock, and Series C Preferred Stock is convertible into one share of the Issuer's common stock immediately prior to the closing of the Issuer's initial public offering. These shares are reported in Table II above on an as-converted 1-to-1 basis and have no expiration date.

(2) Stock held by U.S. Venture Partners XII, L.P. ("USVP XII").

(3) Presidio Management Group XII, L.L.C ("PMG XII") is the general partner of USVP XII and U.S. Venture Partners XII-A, L.P. ("USVP XII-A", and together with USVP XII, the "USVP XII Funds"). Presidio Management Group Select Fund I, L.L.C ("PMG SFI", and, together with USVP XII, USVP XII-A, U.S. Venture Partners Select Fund I, L.P. ("USVP SFI"), U.S. Venture Partners Select Fund I-A, L.P. ("USVP SFI-A"), and PMG XII, "USVP") is the general partner of USVP SFI and USVP SFI-A. PMG XII and PMG SFI may be deemed to share voting and dispositive power over the stock held by USVP.

(4) Each of Jonathan D. Root, Richard W. Lewis, Dafina Toncheva and Steven M. Krausz, are managing members of PMG XII, who may be deemed to share voting and dispositive power over the reported securities held by the USVP XII Funds. In addition, Casey M. Tansey is the managing partner of PMG XII and may be deemed to share voting and dispositive power over the reported securities held by the USVP XII Funds.  Each such persons and entities disclaim beneficial ownership of the reported securities held by the USVP XII Funds, except to the extent of any pecuniary interest therein.

(5) Stock Held by USVP XII-A.

(6) Stock held by USVP SFI, on its own behalf and as nominee for USVP SFI-A.

**Signature:** /s/ Dale Holladay, Authorized Signatory on behalf of Presidio Management Group XII, L.L.C.  
**Date:** 2025-07-22

**Signature:** /s/ Dale Holladay, Authorized Signatory on behalf of U.S. Venture Partners XII, L.P.  
**Date:** 2025-07-22

**Signature:** /s/ Dale Holladay, as Attorney-in-Fact for Casey M. Tansey  
**Date:** 2025-07-22

### Remarks:

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.**