0001178913-17-001727.txt : 20170606 0001178913-17-001727.hdr.sgml : 20170606 20170606175729 ACCESSION NUMBER: 0001178913-17-001727 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170601 FILED AS OF DATE: 20170606 DATE AS OF CHANGE: 20170606 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Integrity Applications, Inc. CENTRAL INDEX KEY: 0001506983 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 980668934 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 19 HA'YAHALOMIM ST STREET 2: P.O. BOX 12163 CITY: ASHDOD STATE: L3 ZIP: L3 7760049 BUSINESS PHONE: 972 (8) 675-7878 MAIL ADDRESS: STREET 1: 19 HA'YAHALOMIM ST STREET 2: P.O. BOX 12163 CITY: ASHDOD STATE: L3 ZIP: L3 7760049 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Seff Leslie CENTRAL INDEX KEY: 0001670027 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-54785 FILM NUMBER: 17895120 MAIL ADDRESS: STREET 1: PO BOX 59, 40 HELLBROOK LANE CITY: ULSTER PARK STATE: NY ZIP: 12487 4 1 zk1720094.xml OWNERSHIP DOCUMENT X0306 4 2017-06-01 0 0001506983 Integrity Applications, Inc. IGAP 0001670027 Seff Leslie C/O INTEGRITY APPLICATIONS, INC. 19 HA'YAHALOMIM ST. P.O. BOX 12163 ASHDOD L3 7760049 ISRAEL 1 0 0 0 Option (Right to Buy) 4.50 2017-06-01 4 A 0 14894 0 A 2027-06-01 Common Stock, par value $0.001 per share 14894 14894 D Restricted Stock Units 1.98 2017-06-01 4 A 0 22727 0 A 2018-06-01 Common Stock, par value $0.001 per share 22727 22727 D The options will vest in equal monthly installments over a one year period commencing on June 1, 2017. The restricted stock units are scheduled to vest on June 1, 2018, assuming continued service as a director through and on such date. The common stock underlying the restricted stock units may be issued on such date as the reporting person elects or upon termination of their service with the Issuer. /s/ Leslie Seff 2017-06-06