0001493152-22-002552.txt : 20220128
0001493152-22-002552.hdr.sgml : 20220128
20220128163042
ACCESSION NUMBER: 0001493152-22-002552
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20220126
FILED AS OF DATE: 20220128
DATE AS OF CHANGE: 20220128
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Sharon Simon
CENTRAL INDEX KEY: 0001851272
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-19871
FILM NUMBER: 22569293
MAIL ADDRESS:
STREET 1: 8 HAMADA STREET
CITY: ZICHRON YAACOV
STATE: L3
ZIP: 3090708
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
2022-01-26
0
0000883975
Microbot Medical Inc.
MBOT
0001851272
Sharon Simon
C/O MICROBOT MEDICAL INC.
25 RECREATION PARK DRIVE, UNIT 108
HINGHAM
MA
02043
0
1
0
0
General Manager, CTO
Stock Option (Right to Buy)
6.48
2022-01-26
4
A
0
25000
0
A
2032-01-26
Common Stock, par value $0.01 per share
25000
25000
D
The options vest as follows and in accordance with the terms of the Issuer's 2020 Omnibus Performance Award Plan (the "Plan"): (a) on July 26, 2022, 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, subject to acceleration pursuant to the terms of the Plan.
/s/ Simon Sharon
2022-01-28