# EDGAR Filing Document

**Accession Number:** 0001534133
**File Stem:** 0001209191-23-020676
**Filing Date:** 2023-3
**Character Count:** 12610
**Document Hash:** 999769d347cac3bec1a59278d4b321f8
**Contains OCR:** False
**Source Format:** 

## Filing Content

## Filing Summary
**0001209191-23-020676.hdr.sgml**: 20230322

**ACCESSION NUMBER**: 0001209191-23-020676

**CONFORMED SUBMISSION TYPE**: 4

**PUBLIC DOCUMENT COUNT**: 1

**CONFORMED PERIOD OF REPORT**: 20230320

**FILED AS OF DATE**: 20230322

**DATE AS OF CHANGE**: 20230322

**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** Leheny A. Rachel
- **CENTRAL INDEX KEY:** 0001484729

**FILING VALUES:**
- **FORM TYPE:** 4
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-39538
- **FILM NUMBER:** 23754257

**MAIL ADDRESS:**
- **STREET 1:** C/O ANTHERA PHARMACEUTICALS, INC.
- **STREET 2:** 25801 INDUSTRIAL BOULEVARD, SUITE B
- **CITY:** HAYWARD
- **STATE:** CA
- **ZIP:** 94545
**ISSUER**: 

**COMPANY DATA:**
- **COMPANY CONFORMED NAME:** CalciMedica, Inc. /DE/
- **CENTRAL INDEX KEY:** 0001534133
- **STANDARD INDUSTRIAL CLASSIFICATION:** PHARMACEUTICAL PREPARATIONS [2834]
- **IRS NUMBER:** 452120079
- **STATE OF INCORPORATION:** DE
- **FISCAL YEAR END:** 1231

**BUSINESS ADDRESS:**
- **STREET 1:** 505 COAST BOULEVARD SOUTH
- **STREET 2:** SUITE 307
- **CITY:** LA JOLLA
- **STATE:** CA
- **ZIP:** 92037
- **BUSINESS PHONE:** 858-952-5500

**MAIL ADDRESS:**
- **STREET 1:** 505 COAST BOULEVARD SOUTH
- **STREET 2:** SUITE 307
- **CITY:** LA JOLLA
- **STATE:** CA
- **ZIP:** 92037

**FORMER COMPANY:**
- **FORMER CONFORMED NAME:** GRAYBUG VISION, INC.
- **DATE OF NAME CHANGE:** 20170717

**FORMER COMPANY:**
- **FORMER CONFORMED NAME:** GRAYBUG, Inc.
- **DATE OF NAME CHANGE:** 20150303

**FORMER COMPANY:**
- **FORMER CONFORMED NAME:** GRAYBUG LLC
- **DATE OF NAME CHANGE:** 20111102

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

## FORM 4

### STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

[ ] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).

[ ] Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan for the purchase or sale of equity securities of the issuer that is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10.

---

| | | |
|:---|:---|:---|
| **1. Name and Address of Reporting Person**<sup>*</sup><br>Leheny A. Rachel<br><sub>(Last) (First) (Middle)</sub><br>C/O CALCIMEDICA, INC.<br>505 COAST S. BLVD. #202<br><sub>(Street)</sub><br>LA JOLLA, CA 92037<br><sub>(City) (State) (Zip)</sub> | **3. Date of Earliest Transaction (Month/Day/Year)**<br>2023-03-20 | **5. Relationship of Reporting Person(s) to Issuer**<br>(Check all applicable)<br>[X] Director [X] 10% Owner<br>[X] Officer (give title below) [ ] Other (specify below)<br>_Chief Executive Officer_ |
| **2. Issuer Name and Ticker or Trading Symbol**<br>CalciMedica, Inc. /DE/ [ CALC ] | **4. If Amendment, Date of Original Filed (Month/Day/Year)**<br>  | **6. Individual or Joint/Group Filing (Check Applicable Line)**<br>[X] Form filed by One Reporting Person<br>[ ] Form filed by More than One Reporting Person |

---

## Table I - Non-Derivative Securities

---

|  |  |  |  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Security | 2. Transaction Date | 2A. Deemed Execution Date | 3. Transaction Code (V) | 3. Transaction Code (V) | 4. Securities Acquired (A) or Disposed of (D) | 4. Securities Acquired (A) or Disposed of (D) | 4. Securities Acquired (A) or Disposed of (D) | 5. Amount of Securities Beneficially Owned | 6. Ownership Form | 7. Nature of Indirect Beneficial Ownership |
| 1. Title of Security | 2. Transaction Date | 2A. Deemed Execution Date | Code | V | Amount | (A) or (D) | Price | 5. Amount of Securities Beneficially Owned | 6. Ownership Form | 7. Nature of Indirect Beneficial Ownership |
| Common Stock | 2023-03-20 |  | A |  | 356989 | A | <sup>(1)</sup> | 356989 | I | By Valence Investments SPV IV, LLC<sup>(2)</sup> |
| Common Stock | 2023-03-20 |  | A |  | 66228 | A | <sup>(3)</sup> | 66228 | I | By Valence Investments SPV V, LLC<sup>(2)</sup> |
| Common Stock | 2023-03-20 |  | A |  | 316109 | A | <sup>(4)</sup> | 316109 | I | By Valence Investments SPV VI, LLC<sup>(2)</sup> |

---

## Table II - Derivative Securities

---

|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Derivative Security | 2. Conversion or Exercise Price | 3. Transaction Date | 3A. Deemed Execution Date | 4. Transaction Code (V) | 4. Transaction Code (V) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) | 6. Date Exercisable and Expiration Date | 6. Date Exercisable and Expiration Date | 7. Title and Amount of Underlying Securities | 7. Title and Amount of Underlying Securities | 8. Price of Derivative Security | 9. Number of Derivative Securities Beneficially Owned | 10. Ownership Form | 11. Nature of Indirect Beneficial Ownership |
| 1. Title of Derivative Security | 2. Conversion or Exercise Price | 3. Transaction Date | 3A. Deemed Execution Date | Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | 8. Price of Derivative Security | 9. Number of Derivative Securities Beneficially Owned | 10. Ownership Form | 11. Nature of Indirect Beneficial Ownership |
| Employee Stock Option (right to buy) | $2.44 | 2023-03-20 |  | A |  | 11232 |  | <sup>(5)</sup> | 2029-04-24 | Common Stock | 11232 | <sup>(6)</sup> | 11232 | D |  |
| Employee Stock Option (right to buy) | $6.60 | 2023-03-20 |  | A |  | 76173 |  | <sup>(5)</sup> | 2030-01-23 | Common Stock | 76173 | <sup>(7)</sup> | 76173 | D |  |
| Employee Stock Option (right to buy) | $6.60 | 2023-03-20 |  | A |  | 30381 |  | <sup>(8)</sup> | 2030-06-29 | Common Stock | 30381 | <sup>(9)(10)</sup> | 30381 | D |  |
| Employee Stock Option (right to buy) | $7.99 | 2023-03-20 |  | A |  | 13964 |  | <sup>(11)</sup> | 2031-04-27 | Common Stock | 13964 | <sup>(9)(12)</sup> | 13964 | D |  |
| Employee Stock Option (right to buy) | $7.99 | 2023-03-20 |  | A |  | 19826 |  | <sup>(13)</sup> | 2031-04-27 | Common Stock | 19826 | <sup>(9)(14)</sup> | 19826 | D |  |
| Employee Stock Option (right to buy) | $7.99 | 2023-03-20 |  | A |  | 13964 |  | <sup>(11)</sup> | 2031-06-30 | Common Stock | 13964 | <sup>(9)(12)</sup> | 13964 | D |  |
| Employee Stock Option (right to buy) | $10.42 | 2023-03-20 |  | A |  | 3552 |  | <sup>(13)</sup> | 2032-08-30 | Common Stock | 3552 | <sup>(9)(15)</sup> | 3552 | D |  |
| Employee Stock Option (right to buy) | $10.42 | 2023-03-20 |  | A |  | 2030 |  | <sup>(13)</sup> | 2032-08-30 | Common Stock | 2030 | <sup>(9)(16)</sup> | 2030 | D |  |
| Employee Stock Option (right to buy) | $10.42 | 2023-03-20 |  | A |  | 1062 |  | <sup>(13)</sup> | 2032-08-30 | Common Stock | 1062 | <sup>(9)(17)</sup> | 1062 | D |  |
| Employee Stock Option (right to buy) | $17.34 | 2023-03-20 |  | A |  | 1717 |  | <sup>(18)</sup> | 2033-03-19 | Common Stock | 1717 | <sup>(9)(19)</sup> | 1717 | D |  |
| Employee Stock Option (right to buy) | $17.34 | 2023-03-20 |  | A |  | 30443 |  | <sup>(18)</sup> | 2033-03-19 | Common Stock | 30443 | <sup>(9)(20)</sup> | 30443 | D |  |
| Employee Stock Option (right to buy) | $17.34 | 2023-03-20 |  | A |  | 12342 |  | <sup>(18)</sup> | 2023-03-19 | Common Stock | 12342 | <sup>(9)(21)</sup> | 12342 | D |  |
| Warrant | $27.94 | 2023-03-20 |  | A |  | 9935 |  | <sup>(13)</sup> | 2026-02-22 | Common Stock | 9935 | <sup>(22)</sup> | 9935 | I | By Valence Investments SPV V, LLC<sup>(2)</sup> |
| Warrant | $27.94 | 2023-03-20 |  | A |  | 9935 |  | <sup>(13)</sup> | 2026-05-25 | Common Stock | 9935 | <sup>(22)</sup> | 9935 | I | By Valence Investments SPV V, LLC<sup>(2)</sup> |

---

### Footnotes:

(1) Received in exchange for an aggregate of 12,395,423 shares of common stock of CalciMedica, Inc. ("CalciMedica") pursuant to an Agreement and Plan of Merger and Reorganization (the "Merger Agreement") by and among CalciMedica, the Issuer and Camaro Merger Sub, Inc., a wholly-owned subsidiary of the Issuer ("Merger Sub"). Under the terms of the Merger Agreement, on March 20, 2023, Merger Sub merged with and into CalciMedica (the "Merger"), with CalciMedica surviving the Merger as a wholly-owned subsidiary of the Issuer. Upon the closing of the Merger, each share of CalciMedica common stock was converted into the right to receive 0.0288 of a share of the Issuer's common stock. Subsequent to the Merger, the name of the Issuer was changed from Graybug Vision, Inc. to CalciMedica, Inc.

(2) The Reporting Person, a co-founder and managing director of Valence Investments SPV IV, LLC ("Valence IV"), Valence Investments SPV V, LLC ("Valence V") and Valence Investments SPV VI, LLC (Valence VI), may be deemed to beneficially own the securities held by Valence IV, Valence V and Valence VI (the "Valence Securities").  The Reporting Person disclaims beneficial ownership of the Valence Securities except to the extent of her pecuniary interest therein.

(3) Received in exchange for 2,299,564 shares of the common stock of CalciMedica pursuant to the Merger Agreement.

(4) Received in exchange for 10,975,977 shares of the common stock of CalciMedica pursuant to the Merger Agreement.

(5) 25% of the shares subject to the option vested on April 30, 2020 and the balance of the shares vest in a series of thirty-six (36) successive equal monthly installments thereafter.

(6) Received in exchange for a stock option to acquire 390,000 shares of common stock of CalciMedica pursuant to the Merger Agreement.

(7) Received in exchange for a stock option to acquire 2,644,900 shares of common stock of CalciMedica pursuant to the Merger Agreement.

(8) 25% of the shares subject to the option vested on June 30, 2020 and the balance of the shares vest in a series of thirty-six (36) successive equal monthly installments thereafter.

(9) Upon the closing of the Merger, each outstanding option to purchase shares of CalciMedica common stock was assumed by the Issuer and converted into an option to purchase the Issuer's common stock.

(10) Received in exchange for a stock option to acquire 1,054,921 shares of common stock of CalciMedica pursuant to the Merger Agreement.

(11) Beginning on February 22, 2021, the shares subject to the option vest in a series of forty-eight (48) successive equal monthly installments.

(12) Received in exchange for a stock option to acquire 484,863 shares of common stock of CalciMedica pursuant to the Merger Agreement.

(13) Immediately exercisable.

(14) Received in exchange for a stock option to acquire 688,404 shares of common stock of CalciMedica pursuant to the Merger Agreement.

(15) Received in exchange for a stock option to acquire 123,357 shares of common stock of CalciMedica pursuant to the Merger Agreement.

(16) Received in exchange for a stock option to acquire 70,490 shares of common stock of CalciMedica pursuant to the Merger Agreement.

(17) Received in exchange for a stock option to acquire 36,905 shares of common stock of CalciMedica pursuant to the Merger Agreement.

(18) Beginning on November 22, 2022, the shares subject to the option vest in a series of forty-eight (48) successive equal monthly installments.

(19) Received in exchange for a stock option to acquire 59,641 shares of common stock of CalciMedica pursuant to the Merger Agreement.

(20) Received in exchange for a stock option to acquire 1,057,071 shares of common stock of CalciMedica pursuant to the Merger Agreement.

(21) Received in exchange for a stock option to acquire 428,566 shares of common stock of CalciMedica pursuant to the Merger Agreement.

(22) Received in exchange for a stock option to acquire 344,934 shares of common stock of CalciMedica pursuant to the Merger Agreement.

**Signature:** By John Dunn, Attorney-in-Fact  
**Date:** 2023-03-22

### 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.**