0001213900-21-063551.txt : 20211206
0001213900-21-063551.hdr.sgml : 20211206
20211206122257
ACCESSION NUMBER: 0001213900-21-063551
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20211202
FILED AS OF DATE: 20211206
DATE AS OF CHANGE: 20211206
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Cohen Assaf
CENTRAL INDEX KEY: 0001733131
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-49877
FILM NUMBER: 211472556
MAIL ADDRESS:
STREET 1: ZHR INDUSTRIAL ZONE, P.O. BOX 32
CITY: ROSH PINA
STATE: L3
ZIP: 1200001
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: ON TRACK INNOVATIONS LTD
CENTRAL INDEX KEY: 0001021604
STANDARD INDUSTRIAL CLASSIFICATION: SEMICONDUCTORS & RELATED DEVICES [3674]
IRS NUMBER: 000000000
STATE OF INCORPORATION: L3
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: HATNUFA 5
STREET 2: YOKNEAM INDUSTRIAL ZONE
CITY: YOKNEAM
STATE: L3
ZIP: 2069200
BUSINESS PHONE: 972 4 686-8021
MAIL ADDRESS:
STREET 1: HATNUFA 5
STREET 2: YOKNEAM INDUSTRIAL ZONE
CITY: YOKNEAM
STATE: L3
ZIP: 2069200
4
1
ownership.xml
X0306
4
2021-12-02
0
0001021604
ON TRACK INNOVATIONS LTD
OTIVF
0001733131
Cohen Assaf
HATNUFA 5, YOKNEAM INDUSTRIAL ZONE
BOX 372
YOKNEAM
L3
2069200
ISRAEL
0
1
0
0
Chief Financial Officer
Ordinary Shares
2021-12-02
4
A
0
400000
A
400000
D
Stock Option (right to buy)
1.21
2021-12-02
4
D
0
15000
0
D
Ordinary Shares
15000
0
D
Stock Option (right to buy)
0.84
2021-12-02
4
D
0
20000
0
D
Ordinary Shares
20000
0
D
Stock Option (right to buy)
0.38
2021-12-02
4
D
0
100000
0
D
Ordinary Shares
100000
0
D
Stock Option (right to buy)
0.22
2021-12-02
4
D
0
50000
0
D
Ordinary Shares
50000
0
D
Upon vesting of such ordinary shares, as described in Note 2 below, the Reporting Person shall be required to pay the par value of the shares no longer subject to restriction of NIS 0.1.
The ordinary shares vest as follows: (i) 50,000 shares will vest in two equal instalments on each of 12/02/2022 and 12/02/2023; and (ii) 350,000 shares will vest in three equal instalments on each of 12/02/2022, 12/02/2023 and 12/02/2024, all subject to the terms and provisions of the Issuer's 2021 equity incentive plan.
The options were disposed of to the Issuer according to the Reporting Person's consent to the cancellation thereof in connection with the grant of the ordinary shares listed in Table I.
/s/ Assaf Cohen
2021-12-06