0001493152-17-014280.txt : 20171206
0001493152-17-014280.hdr.sgml : 20171206
20171206182921
ACCESSION NUMBER: 0001493152-17-014280
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20171205
FILED AS OF DATE: 20171206
DATE AS OF CHANGE: 20171206
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Bornstein Yoseph
CENTRAL INDEX KEY: 0001690100
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-19871
FILM NUMBER: 171243167
MAIL ADDRESS:
STREET 1: 16 IRUS STREET
CITY: ROSH HA'AYIN
STATE: L3
ZIP: 4858022
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Microbot Medical Inc.
CENTRAL INDEX KEY: 0000883975
STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836]
IRS NUMBER: 943078125
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 175 DERBY ST. 27/1
STREET 2: .
CITY: HINGHAM
STATE: MA
ZIP: 02043
BUSINESS PHONE: 908-938-5561
MAIL ADDRESS:
STREET 1: 175 DERBY ST. 27/1
STREET 2: .
CITY: HINGHAM
STATE: MA
ZIP: 02043
FORMER COMPANY:
FORMER CONFORMED NAME: STEMCELLS INC
DATE OF NAME CHANGE: 20000524
FORMER COMPANY:
FORMER CONFORMED NAME: CYTOTHERAPEUTICS INC/DE
DATE OF NAME CHANGE: 19930328
4
1
form4.xml
X0306
4
2017-12-05
0
0000883975
Microbot Medical Inc.
MBOT
0001690100
Bornstein Yoseph
C/O MICROBOT MEDICAL INC.
25 RECREATION PARK DRIVE, UNIT 108
HINGHAM
MA
02043
1
0
1
0
Common Stock
2017-12-05
4
S
0
29625
1.0845
D
4760784
I
By LSA- LifeScience Accelerator Ltd.
Reporting Person, through his Rule 10b5-1 trading plan, sold an aggregate of 29,625 shares of Issuer common stock on December 5, 2017. Accordingly, Reporting Person beneficially owned 4,760,784 shares of Issuer common stock following the reported transactions.
Mr. Bornstein is the CEO and Director of LSA- Life Science Accelerator Ltd. ("LSA") and of Shizim Ltd. ("Shizim"), and Mr. Bornstein is the majority equity owner of Shizim. Shizim is the majority equity owner of LSA. Accordingly, Mr. Bornstein may be deemed to share voting and investment power over the shares beneficially owned by these entities.
/s/ Yoseph Bornstein
2017-12-06