0001493152-18-000959.txt : 20180124 0001493152-18-000959.hdr.sgml : 20180124 20180124133205 ACCESSION NUMBER: 0001493152-18-000959 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20171228 FILED AS OF DATE: 20180124 DATE AS OF CHANGE: 20180124 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Naim David Ben CENTRAL INDEX KEY: 0001692130 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-19871 FILM NUMBER: 18544732 MAIL ADDRESS: STREET 1: 5 DOVNOV STREET CITY: HOLON STATE: L3 ZIP: 58102 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Microbot Medical Inc. CENTRAL INDEX KEY: 0000883975 STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836] IRS NUMBER: 943078125 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 175 DERBY ST. 27/1 STREET 2: . CITY: HINGHAM STATE: MA ZIP: 02043 BUSINESS PHONE: 908-938-5561 MAIL ADDRESS: STREET 1: 175 DERBY ST. 27/1 STREET 2: . CITY: HINGHAM STATE: MA ZIP: 02043 FORMER COMPANY: FORMER CONFORMED NAME: STEMCELLS INC DATE OF NAME CHANGE: 20000524 FORMER COMPANY: FORMER CONFORMED NAME: CYTOTHERAPEUTICS INC/DE DATE OF NAME CHANGE: 19930328 4 1 form4.xml X0306 4 2017-12-28 0 0000883975 Microbot Medical Inc. MBOT 0001692130 Naim David Ben C/O MICROBOT MEDICAL INC. 25 RECREATION PARK DRIVE, UNIT 108 HINGHAM MA 02043 0 1 0 0 Chief Financial Officer Stock Option (Right to Buy) 1.02 2017-12-28 4 A 0 75000 0 A 2027-12-28 Common Stock, par value $0.01 per share 75000 75000 D The options vest as follows and in accordance with the terms of the Issuer's 2017 Equity Incentive Plan: (a) on the six month anniversary of the date of grant, the option shall vest and shall become exercisable with respect to 25% of the common stock; and (b) on a quarterly basis over the next 30 months, the option shall equally vest and become exercisable with respect to the remaining 75% of the common stock. /s/ David Ben Naim 2018-01-24