0001178913-17-001782.txt : 20170609
0001178913-17-001782.hdr.sgml : 20170609
20170609112100
ACCESSION NUMBER: 0001178913-17-001782
CONFORMED SUBMISSION TYPE: 4/A
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20170601
FILED AS OF DATE: 20170609
DATE AS OF CHANGE: 20170609
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: SCHWARTZ REVAN
CENTRAL INDEX KEY: 0001690043
FILING VALUES:
FORM TYPE: 4/A
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-54785
FILM NUMBER: 17901895
MAIL ADDRESS:
STREET 1: 19 HA'YAHALOMIM ST., P.O. BOX 12163
STREET 2: C/O INTEGRITY APPLICATIONS, INC.
CITY: ASHDOD
STATE: L3
ZIP: 7760049
4/A
1
a1720119.xml
OWNERSHIP DOCUMENT
X0306
4/A
2017-06-01
2017-06-06
0
0001506983
Integrity Applications, Inc.
IGAP
0001690043
SCHWARTZ REVAN
19 HA'YAHALOMIM ST., P.O. BOX 12163
C/O INTEGRITY APPLICATIONS, INC.
ASHDOD
L3
7760049
ISRAEL
1
0
0
0
Restricted Stock Units
0
2017-06-01
4
A
0
22727
0
A
2018-06-01
Common Stock, par value $0.001 per share
22727
22727
D
The restricted stock units do not have a conversion or exercise price. The reporting person's original Form 4 included a conversion price of $1.98.
The restricted stock units are scheduled to vest on June 1, 2018, assuming continued service as a director through and on such date.
After June 1, 2018, 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/ Revan Schwartz
2017-06-09