0001575872-22-000336.txt : 20220426 0001575872-22-000336.hdr.sgml : 20220426 20220426213728 ACCESSION NUMBER: 0001575872-22-000336 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220426 FILED AS OF DATE: 20220426 DATE AS OF CHANGE: 20220426 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Hochschuler Stephen CENTRAL INDEX KEY: 0001378563 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41364 FILM NUMBER: 22856072 MAIL ADDRESS: STREET 1: C/O TENON MEDICAL, INC. STREET 2: 104 COOPER COURT CITY: LOS GATOS STATE: CA ZIP: 95032 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Tenon Medical, Inc. CENTRAL INDEX KEY: 0001560293 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 455574718 STATE OF INCORPORATION: DE BUSINESS ADDRESS: STREET 1: 90 WEST MAIN AVE. STREET 2: SUITE 6 CITY: MORGAN HILL STATE: CA ZIP: 95037 BUSINESS PHONE: 863-673-4062 MAIL ADDRESS: STREET 1: 90 WEST MAIN AVE. STREET 2: SUITE 6 CITY: MORGAN HILL STATE: CA ZIP: 95037 3 1 ownership.xml X0206 3 2022-04-26 0 0001560293 Tenon Medical, Inc. TNON 0001378563 Hochschuler Stephen 104 COOPER COURT LOS GATOS CA 95032 1 0 0 0 Common Stock 19725 I See footnote Common Stock 24900 D Stock Options 0.62 2016-12-15 2026-11-15 Common Stock 8536 D Consists of (i) 15,253 shares of common stock issuable to SHKH, LLC, an entity for which Stephen H. Hochschuler has a controlling interest, upon the automatic conversion of a convertible note on the closing of the initial public offering of Tenon Medical, Inc. to occur on April 29, 2022, and (ii) 4,472 shares of common stock issuable to SHKH, LLC upon the conversion of Series B Preferred Stock on the closing of the initial public offering. Stephen Hochschuler was granted an option to purchase 17,071 shares (or 8,536 shares after the 1-for-2 reverse stock split was effectuated on April 6, 2022) of common stock at an exercise price of $0.31 (or $0.62 post-split) per share with a grant date of November 15, 2016. All of the shares underlying the option have vested. /s/ Stephen H. Hochschuler 2022-04-26