0001493152-21-002536.txt : 20210203 0001493152-21-002536.hdr.sgml : 20210203 20210203171552 ACCESSION NUMBER: 0001493152-21-002536 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210201 FILED AS OF DATE: 20210203 DATE AS OF CHANGE: 20210203 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Gadot Harel CENTRAL INDEX KEY: 0001690103 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-19871 FILM NUMBER: 21587240 MAIL ADDRESS: STREET 1: 5 VILLAGE LANE CITY: HINGHAM STATE: MA ZIP: 02043 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: 25 RECREATION PARK DR SUITE 108 CITY: HINGHAM STATE: MA ZIP: 02043 BUSINESS PHONE: 908-938-5561 MAIL ADDRESS: STREET 1: 25 RECREATION PARK DR SUITE 108 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 ownership.xml X0306 4 2021-02-01 0 0000883975 Microbot Medical Inc. MBOT 0001690103 Gadot Harel C/O MICROBOT MEDICAL INC. 25 RECREATION PARK DRIVE, UNIT 108 HINGHAM MA 02043 1 1 0 0 Chairman, President and CEO Stock Option (Right to Buy) 8.48 2021-02-01 4 A 0 190000 0 A 2031-02-01 Common Stock, par value $0.01 per share 190000 190000 D The options vest as follows and in accordance with the terms of the Issuer's 2020 Omnibus Performance Award Plan: (a) on February 1, 2022, the options shall vest and shall become exercisable with respect to 50% of the common stock; and (b) on a quarterly basis thereafter over the following year, the option shall equally vest and become exercisable with respect to the remaining 50% of the common stock. /s/ Harel Gadot 2021-02-02