0001493152-21-032872.txt : 20211230 0001493152-21-032872.hdr.sgml : 20211230 20211230170106 ACCESSION NUMBER: 0001493152-21-032872 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211229 FILED AS OF DATE: 20211230 DATE AS OF CHANGE: 20211230 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Goldstein Martin M CENTRAL INDEX KEY: 0001639061 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36445 FILM NUMBER: 211533504 MAIL ADDRESS: STREET 1: C/O NANOVIBRONIX, INC. STREET 2: 525 EXECUTIVE BOULEVARD CITY: ELMSFORD STATE: NY ZIP: 10523 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 X0306 4 2021-12-29 0 0001326706 NanoVibronix, Inc. NAOV 0001639061 Goldstein Martin M C/O NANOVIBRONIX, INC. 525 EXECUTIVE BOULEVARD ELMSFORD NY 10523 1 0 0 0 Option to Purchase Common Stock 1.01 2021-12-29 4 A 0 50000 0 A 2031-12-28 Common Stock 50000 50000 D 25% of the option vested on December 29, 2021 (the "Date of Grant"), with an additional 25% to vest on the three-month anniversary of the Date of Grant, a further 25% to vest on the six-month anniversary of the Date of Grant, and the final 25% to vest on the nine-month anniversary of the 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. /s/ Martin Goldstein 2021-12-30