0001213900-22-080901.txt : 20221219
0001213900-22-080901.hdr.sgml : 20221219
20221219161146
ACCESSION NUMBER: 0001213900-22-080901
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20221215
FILED AS OF DATE: 20221219
DATE AS OF CHANGE: 20221219
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Ruderman Jan
CENTRAL INDEX KEY: 0001927476
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-41375
FILM NUMBER: 221471197
MAIL ADDRESS:
STREET 1: C/O ACTELIS NETWORKS, INC.
STREET 2: 47800 WESTINGHOUSE DRIVE
CITY: FREMONT
STATE: CA
ZIP: 94539
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: ACTELIS NETWORKS INC
CENTRAL INDEX KEY: 0001141284
STANDARD INDUSTRIAL CLASSIFICATION: COMMUNICATIONS EQUIPMENT, NEC [3669]
IRS NUMBER: 522160309
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 4039 CLIPPER COURT
CITY: FREMONT
STATE: CA
ZIP: 94538
BUSINESS PHONE: 510-545-1040
MAIL ADDRESS:
STREET 1: 4039 CLIPPER COURT
CITY: FREMONT
STATE: CA
ZIP: 94538
4
1
ownership.xml
X0306
4
2022-12-15
0
0001141284
ACTELIS NETWORKS INC
ASNS
0001927476
Ruderman Jan
4039 CLIPPER COURT
FREMONT
CA
94538
0
1
0
0
CRO-Americas
Restricted Stock Unit
2022-12-15
4
A
0
68000
0
A
Common Stock, $0.0001 par value
68000
68000
D
The first third of the Restricted Stock Units ("RSUs") will vest on September 29, 2023 ("Vesting Date"), with the remaining two-thirds of the RSUs vesting in equal increments over the next two years on each annual anniversary date following the Vesting Date, until September 29, 2025, at which point the RSU grants shall be fully vested, subject to the Reporting Person remaining continuously employed through the final Vesting Date, unless the Reporting Person's engagement with the Issuer is terminated, in which case the unvested RSUs will vest at the termination date, based on the upcoming annual anniversary amount, pro-rated to the date of termination. Each RSU represents a contingent right to receive one share of the Issuer's common stock or the cash value thereof.
The board of directors of the Issuer, in its sole discretion, will determine in accordance with the terms and conditions of the Issuer's 2015 Equity Incentive Plan, as amended, the form of payout of the RSUs (cash and/or stock).
/s/ Jan Ruderman
2022-12-19