SEC Form 4 · accession 0001144204-18-050922
DarioHealth Corp. · DRIO
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Yoav Shaked
Director
Period of report
Sep 13, 2018
Accepted (ET)
Sep 26, 2018 · 4:06 pm EDT
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 StockF1 | Sep 13, 2018 | P | 12,376 | $0.90 | A | 12,376 | I | By spouse |
| Common Stock | holding | — | — | — | 270 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Series D Convertible Preferred StockF1,F2 | $0.90 | Sep 13, 2018 | P | 5,240 | A | — | — | Common Stock | 20,960 | 5,240 | I |
| Warrant to purchase Common StockF1,F3 | $1.25 | Sep 13, 2018 | P | 26,669 | A | Aug 28, 2018 | Aug 28, 2019 | Common Stock | 26,669 | 26,669 | I |
Explanation of responses
- F1The reporting person disclaims beneficial ownership of these securities, and this report shall not be deemed an admission that the reporting person is the beneficial owner of such securities for purposes of Section 16 or for any other purpose.
- F2The Series D Convertible Preferred Stock automatically converts into Common Stock on a 1:4 basis upon shareholder approval of the conversion and has no expiration date.
- F3The Warrants were issued in connection with the purchase of the Common Stock and the Series D Convertible Preferred Stock reported herein.