0001493152-23-043633.txt : 20231204 0001493152-23-043633.hdr.sgml : 20231204 20231204204511 ACCESSION NUMBER: 0001493152-23-043633 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20231115 FILED AS OF DATE: 20231204 DATE AS OF CHANGE: 20231204 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MIKA THOMAS CENTRAL INDEX KEY: 0001263576 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36445 FILM NUMBER: 231464972 MAIL ADDRESS: STREET 1: TEGAL CORP STREET 2: 2201 SOUTH MCDOWELL BLVD CITY: PETALUMA STATE: CA ZIP: 94954 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: NanoVibronix, Inc. CENTRAL INDEX KEY: 0001326706 STANDARD INDUSTRIAL CLASSIFICATION: ORTHOPEDIC, PROSTHETIC & SURGICAL APPLIANCES & SUPPLIES [3842] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 525 EXECUTIVE BLVD CITY: ELMSFORD STATE: NY ZIP: 10523 BUSINESS PHONE: (914) 233-3004 MAIL ADDRESS: STREET 1: 525 EXECUTIVE BLVD CITY: ELMSFORD STATE: NY ZIP: 10523 FORMER COMPANY: FORMER CONFORMED NAME: Nano Vibronix, Inc. DATE OF NAME CHANGE: 20111206 FORMER COMPANY: FORMER CONFORMED NAME: Nano Vibronix Inc DATE OF NAME CHANGE: 20050510 4 1 ownership.xml X0508 4 2023-11-15 0 0001326706 NanoVibronix, Inc. NAOV 0001263576 MIKA THOMAS C/O NANOVIBRONIX, INC. 525 EXECUTIVE BOULEVARD ELMSFORD NY 10523 1 0 0 0 0 Option to Purchase Common Stock 1.24 2023-11-15 4 A 0 3334 0 A 2033-11-15 Common Stock 3334 3334 D Option to Purchase Common Stock 32.00 2023-11-29 4 D 0 1500 0 D 2020-07-13 2030-07-13 Common Stock 1500 0 D Option to Purchase Common Stock 8.94 2023-11-29 4 D 0 3000 0 D 2032-09-13 Common Stock 3000 0 D Option to Purchase Common Stock 14.40 2023-11-29 4 D 0 2000 0 D 2020-10-01 2030-10-01 Common Stock 2000 0 D Option to Purchase Common Stock 16.80 2023-11-29 4 D 0 4500 0 D 2030-12-22 Common Stock 4500 0 D Option to Purchase Common Stock 20.20 2023-11-29 4 D 0 3000 0 D 2031-12-29 Common Stock 3000 0 D 100% of the option vested on November 15, 2023, in accordance with that certain option agreement entered into by and between the Issuer and the reporting person and the NanoVibronix, Inc. 2014 Long-Term Incentive Plan. 25% of the option vested on September 13, 2022 (the "2022 Date of Grant"), with an additional 25% to vest on the three-month anniversary of the 2022 Date of Grant, a further 25% to vest on the six-month anniversary of the 2022 Date of Grant, and the final 25% to vest on the nine-month anniversary of the 2022 Date of Grant, in accordance with that certain option agreement entered into by and between the Issuer and the reporting person and the NanoVibronix, Inc. 2014 Long-Term Incentive Plan. 20% of the option vested on December 22, 2020 (the "2020 Date of Grant"), with an additional 20% vested on the three month anniversary of the 2020 Date of Grant, a further 20% vested on the six month anniversary of the 2020 Date of Grant, a further 20% vested on the nine month anniversary of the 2020 Date of Grant, and the final 20% vested on the year anniversary of the 2020 Date of Grant, in accordance with that certain option agreement entered into by and between the Issuer and the reporting person and the NanoVibronix, Inc. 2014 Long-Term Incentive Plan. 25% of the option vested on December 29, 2021 (the " 2021 Date of Grant"), with an additional 25% vested on the three-month anniversary of the 2021 Date of Grant, a further 25% vested on the six-month anniversary of the 2021 Date of Grant, and the final 25% vested on the nine-month anniversary of the 2021 Date of Grant, in accordance with that certain option agreement entered into by and between the Issuer and the reporting person and the NanoVibronix, Inc. 2014 Long-Term Incentive Plan. The options were canceled by mutual agreement of the reporting person and NanoVibronix, Inc. The reporting person received $1.00 as the aggregate consideration for the cancellations. /s/ Thomas Mika 2023-12-04