0001104659-20-085626.txt : 20200722 0001104659-20-085626.hdr.sgml : 20200722 20200722161032 ACCESSION NUMBER: 0001104659-20-085626 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20200720 FILED AS OF DATE: 20200722 DATE AS OF CHANGE: 20200722 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Raphael Erez CENTRAL INDEX KEY: 0001668046 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37704 FILM NUMBER: 201041607 MAIL ADDRESS: STREET 1: 9 HALAMISH STREET STREET 2: CAESAREA INDUSTRIAL PARK CITY: CAESAREA STATE: L3 ZIP: 38900 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: DarioHealth Corp. CENTRAL INDEX KEY: 0001533998 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 452973162 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 8 HATOKHEN ST. CITY: CAESAREA STATE: L3 ZIP: 38900 BUSINESS PHONE: (972)-(3)-6222929 MAIL ADDRESS: STREET 1: 8 HATOKHEN ST. CITY: CAESAREA STATE: L3 ZIP: 38900 FORMER COMPANY: FORMER CONFORMED NAME: LabStyle Innovations Corp. DATE OF NAME CHANGE: 20111101 4 1 tm2025176d5_4.xml OWNERSHIP DOCUMENT X0306 4 2020-07-20 0 0001533998 DarioHealth Corp. DRIO 0001668046 Raphael Erez 8 HATOKHEN STREET CAESAREA INDUSTRIAL PARK L3 3088900 ISRAEL 1 1 0 0 Chief Executive Officer Common Stock 2020-07-20 4 P 0 15593 0 A 521313 D Common Stock 37876 I By Dicilyon Consulting and Investment Ltd. The reporting person was awarded such securities in exchange for waiving compensation owed for the third quarter of 2020. The amount shown represents the beneficial ownership of the issuer's securities held by Dicilyon Consulting and Investment Ltd. which may be deemed to be attributable to Mr. Raphael because Mr. Raphael possesses voting and dispositive power over the securities held by Dicilyon Consulting and Investment Ltd. by virtue of a proxy. Mr. Raphael disclaims beneficial ownership of the securities set forth herein. /s/ Erez Raphael 2020-07-22