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*
Hirsch Stanley

(Last) (First) (Middle)
C/O FOAMIX PHARMACEUTICALS LTD.
2 HOLZMAN 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) X Other (specify below)
Chairman of the Board
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 6,448 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 6,224 $5.04 D
Options (1) 12/29/2024 Ordinary Shares 27,000 $5.88 D
Options (2) 07/13/2027 Ordinary Shares 82,153 $4.69 D
Options 01/01/2004 11/25/2019 Ordinary Shares 182,500 $0.62 I See footnote(3)
Restricted Share Units (4) (4) Ordinary Shares 6,466 $0.00 D
Explanation of Responses:
1. The Options vest over a period of three years from December 29, 2014 (33.3% on each anniversary of such date) and ending December 29, 2017
2. The Options vest over a period of four years from July 13, 2017 (25% on the first anniversary of such date and 6.25% every three months thereafter) and ending July 13, 2021
3. Options held by ZEAS Technology and Science Management Ltd., a company beneficially owned by Stanley Hirsch
4. The Restricted Share Units vest over a period of three years (33.3% at each anniversary) beginning July 13, 2017 and ending July 13, 2021.
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 Stanley Hirsch 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.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.