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