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