SEC Form 4 · accession 0001144204-17-059417

DarioHealth Corp. · DRIO

Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗

Reporting owner

Director · 10% Owner

Period of report

Nov 13, 2017

Accepted (ET)

Nov 15, 2017 · 4:05 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^F1	Nov 13, 2017	A	496,031	$0.00	A	1,388,889	I	See Footnote
Common Stock	holding	—	—		—	6,639	D

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
Warrant to purchase Common Stock^F1	$3.50	Nov 13, 2017	J	892,858	D	Jul 10, 2017	Jan 9, 2022	Common Stock	892,858	0	I

F1On November 13, 2017, DarioHealth Corp. (the "Company") and OurCrowd Digital Health L.P. ("OurCrowd") entered into a warrant exchange agreement whereby OurCrowd agreed to surrender a warrant to purchase 892,858 shares of the Company's common stock in exchange for 496,031 restricted shares of the Company's common stock. The amounts shown represent the beneficial ownership or the issuer's securities by OurCrowd, which may be deemed attributable to Mr. Kamer because Mr. Kamer is a Managing Partner of OurCrowd. Mr. Kamer disclaims beneficial ownership of the securities set forth herein except to the extent of their pecuniary interest therein.