SEC Form 4 · accession 0001178913-17-001121
Integrity Applications, Inc. · GCTK
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
David Malka
Officer — Vice President of Operations
Period of report
Apr 13, 2017
Accepted (ET)
Apr 14, 2017 · 4:20 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001506983
Table I — non-derivative securities
No Table I lines on this filing.
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Option (Right to Buy)F1,F2 | $4.50 | Apr 13, 2017 | A | 361,875 | A | — | Apr 13, 2027 | Common Stock, par value $0.001 per share | 361,875 | 361,875 | D |
| Option (Right to Buy)F3 | $7.75 | Apr 13, 2017 | A | 266,617 | A | — | Apr 13, 2027 | Common Stock, par value $0.001 per share | 266,617 | 266,617 | D |
| Option (Right to Buy)F5,F6 | $4.50 | Apr 13, 2017 | A | 25,000 | A | — | — | Common Stock, par value $0.001 per share | 25,000 | 25,000 | D |
Explanation of responses
- F1On a fully diluted basis.
- F2The options shall vest over a three-year period commencing on April 13, 2017.
- F3The option shall vest 50% upon CFDA approval and 50% upon FDA approval.
- F4Pursuant to the employment agreement entered into by the Company's wholly owned subsidiary, A.D. Integrity Applications Ltd. and the Reporting Person, the grant of the options to purchase common stock is subject to the Company reaching certain corporate development milestones.
- F5The option shall vest over a three year period beginning on the date of grant as set forth in Note 4.
- F6The option shall expire upon the ten (10) year anniversary of the date of grant as set forth in Note 4.