SEC Form 4 · accession 0001144204-17-005358
DarioHealth Corp. · DRIO
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Erez Raphael
Officer — Chief Executive Officer · Director
Period of report
Jan 30, 2017
Accepted (ET)
Feb 1, 2017 · 4:07 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001533998
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock | Jan 30, 2017 | A | 227,616 | $0.00 | A | 349,950 | D | |
| Common StockF1 | Jan 30, 2017 | A | 11,381 | $0.00 | A | 361,331 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock Option (right to buy)F2 | $3.202 | Jan 30, 2017 | A | 143,164 | A | — | Jan 30, 2023 | Common Stock | 143,164 | 143,164 | D |
Explanation of responses
- F1The reporting person was awarded such securities in exchange for waiving compensation owed for the first quarter of 2017 in the amount of $36,443.60.
- F2The option vests in twelve equal quarterly installments commencing on January 30, 2017.