SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person*
Bacher Dror

(Last) (First) (Middle)
9 HALAMISH STREET

(Street)
CAESAREA INDUSTRIAL PARK L3 3088900

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
07/25/2017
3. Issuer Name and Ticker or Trading Symbol
DarioHealth Corp. [ DRIO ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Chief Operating Officer
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 102,474 D
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Employee Stock Option (right to buy) (1) 01/06/2024 Common Stock 1,334 $166.5 D
Employee Stock Option (right to buy) (2) 07/07/2024 Common Stock 1,334 $88.2 D
Employee Stock Option (right to buy) (3) 09/03/2021 Common Stock 25,338 $5.76 D
Employee Stock Option (right to buy) (4) 12/17/2021 Common Stock 9,584 $7.02 D
Employee Stock Option (right to buy) (5) 01/30/2023 Common Stock 27,492 $3.202 D
Common Stock Purchase Warrant 07/23/2015 07/23/2018 Common Stock 278 $7.2 D
Explanation of Responses:
1. The option vested in 8 equal quarterly installments beginning on April 7, 2014.
2. The option vested in 8 equal quarterly installments beginning on October 7, 2014.
3. The option vests 33% on the September 3, 2015 and the balance in 8 equal instalments beginning on December 3, 2015.
4. The option vests 33% after one year and the balance in 8 equal instalments beginning on March 17, 2017.
5. The option vests in 12 equal quarterly instalments beginning on April 30, 2017.
/s/ Dror Bacher 07/26/2017
** Signature of Reporting Person Date
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 5 (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.
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