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