SEC Form 4 · accession 0001493152-17-010332
Microbot Medical Inc. · MBOT
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Yoseph Bornstein
Director · 10% Owner
Period of report
Sep 6, 2017
Accepted (ET)
Sep 7, 2017 · 7:22 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000883975
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Sep 6, 2017 | S | 25,000 | $1.00 | D | 5,245,409 | I | By LSA- LifeScience Accelerator Ltd. |
| Common StockF1 | Sep 6, 2017 | S | 610 | $1.08 | D | 5,244,799 | I | By LSA- LifeScience Accelerator Ltd. |
| Common StockF1 | Sep 6, 2017 | S | 20,000 | $1.01 | D | 5,224,799 | I | By LSA- LifeScience Accelerator Ltd. |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1Mr. Bornstein is the CEO and Director of LSA- Life Science Accelerator Ltd. ("LSA") and of Shizim Ltd. ("Shizim"), and Mr. Bornstein is the majority equity owner of Shizim. Shizim is the majority equity owner of LSA. Accordingly, Mr. Bornstein may be deemed to share voting and investment power over the shares beneficially owned by these entities.