0001493152-22-004603.txt : 20220214 0001493152-22-004603.hdr.sgml : 20220214 20220214212110 ACCESSION NUMBER: 0001493152-22-004603 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211231 FILED AS OF DATE: 20220214 DATE AS OF CHANGE: 20220214 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Huntsman Ronald Kirk CENTRAL INDEX KEY: 0001835498 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39796 FILM NUMBER: 22636728 MAIL ADDRESS: STREET 1: 9137 RIDGELINE BOULEVARD, SUITE 135 CITY: HIGHLANDS RANCH STATE: CO ZIP: 80129 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Vivos Therapeutics, Inc. CENTRAL INDEX KEY: 0001716166 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 813224056 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 9137 RIDGELINE BOULEVARD STREET 2: SUITE 135 CITY: HIGHLANDS RANCH STATE: CO ZIP: 80129 BUSINESS PHONE: (866)908-4867 MAIL ADDRESS: STREET 1: 9137 RIDGELINE BOULEVARD STREET 2: SUITE 135 CITY: HIGHLANDS RANCH STATE: CO ZIP: 80129 FORMER COMPANY: FORMER CONFORMED NAME: Vivos BioTechnologies, Inc. DATE OF NAME CHANGE: 20170901 5 1 ownership.xml X0306 5 2021-12-31 0 0 0 0001716166 Vivos Therapeutics, Inc. VVOS 0001835498 Huntsman Ronald Kirk 9137 S. RIDGELINE BLVD, SUITE 135 HIGHLANDS RANCH CO 80129 1 1 0 0 Chief Executive Officer Stock Option (Right to Buy) 5.64 2021-06-16 5 A 0 125000 5.64 A 2026-06-26 Common Stock 125000 125000 D An option for the purchase of 125,000 shares was granted on June 16, 2021. The option vests one fifth immediately and one-fifth annually on each anniversary date through June 16, 2025. /s/ Brad Amman as attorney-in-fact for R. Kirk Huntsman 2022-02-14