SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person*
Tamarkin Dov

(Last) (First) (Middle)
C/O FOAMIX PHARMACEUTICALS LTD.
2 HOLTZMAN STREET

(Street)
REHOVOT L3 7670402

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
01/01/2018
3. Issuer Name and Ticker or Trading Symbol
Foamix Pharmaceuticals Ltd. [ FOMX ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Ordinary Shares 2,563,489 I See footnote(1)
Ordinary Shares 11,239 D
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Warrants 05/13/2014 05/13/2018 Ordinary Shares 2,094 $5.04 I See footnote(1)
Options (2) 12/29/2024 Ordinary Shares 24,000 $5.88 D
Options (3) 12/29/2024 Ordinary Shares 45,000 $6.77 D
Options (4) 03/01/2026 Ordinary Shares 100,000 $6.34 D
Restricted Share Units (5) (5) Ordinary Shares 5,625 $0.00 D
Explanation of Responses:
1. Shares and Warrants held by Tamarkin Medical Innovation Ltd., an Israeli company controlled by Dr. Dov Tamarkin
2. The Options vested over a period of three years from December 29, 2014 (33.3% on each anniversary of such date) and ending December 29, 2017
3. Options vest over a period of four years from December 29, 2014 (25% on the first anniversary of such date and 6.25% every three months thereafter) and ending December 29, 2018
4. Options vest over a period of four years from March 1, 2016 (25% on the first anniversary of such date and 6.25% every three months thereafter) and ending March 1, 2020
5. The Restricted Share Units vest in equal installments every three months over the vesting period beginning October 15, 2017 and ending January 15, 2019.
Remarks:
The Reporting Person is filing this form in connection with the Issuer's transition from a foreign private issuer to a domestic issuer, effective January 1, 2018. Exhibit List: Exhibit 24 - Power of Attorney
/s/ Ilan Hadar as attorney-in-fact for Dov Tamarkin 01/11/2018
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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