0001213900-23-041173.txt : 20230518
0001213900-23-041173.hdr.sgml : 20230518
20230518160542
ACCESSION NUMBER: 0001213900-23-041173
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20230517
FILED AS OF DATE: 20230518
DATE AS OF CHANGE: 20230518
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Barlev Tuvia
CENTRAL INDEX KEY: 0001927656
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-41375
FILM NUMBER: 23936068
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
X0407
4
2023-05-17
0
0001141284
ACTELIS NETWORKS INC
ASNS
0001927656
Barlev Tuvia
4039 CLIPPER COURT
FREMONT
CA
94538
1
1
0
0
CEO and Chairman of the Board
0
Common stock, par value $0.0001
2023-05-17
4
S
0
2107
3.32
D
163598
D
The sale reported on this Form 4 represents shares sold by the Reporting Person to cover tax withholding obligations in connection with the vesting and settlement of Restricted Stock Units ("RSUs"). The sale is mandated by the Issuer's election to require the satisfaction of tax withholding obligations to be funded by a "sell to cover" transaction and does not represent a discretionary transaction by the Reporting Person.
/s/ Tuvia Barlev
2023-05-18