0001387131-16-008657.txt : 20161221 0001387131-16-008657.hdr.sgml : 20161221 20161221161929 ACCESSION NUMBER: 0001387131-16-008657 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20161220 FILED AS OF DATE: 20161221 DATE AS OF CHANGE: 20161221 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: BLUE SPHERE CORP. CENTRAL INDEX KEY: 0001419582 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER PROGRAMMING, DATA PROCESSING, ETC. [7370] IRS NUMBER: 980550257 STATE OF INCORPORATION: NV FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 301 MCCULLOUGH DRIVE STREET 2: 4TH FLOOR CITY: CHARLOTTE STATE: NC ZIP: 28262 BUSINESS PHONE: 704-909-2806 MAIL ADDRESS: STREET 1: 301 MCCULLOUGH DRIVE STREET 2: 4TH FLOOR CITY: CHARLOTTE STATE: NC ZIP: 28262 FORMER COMPANY: FORMER CONFORMED NAME: Blue Sphere Corp DATE OF NAME CHANGE: 20100219 FORMER COMPANY: FORMER CONFORMED NAME: Jin Jie Corp. DATE OF NAME CHANGE: 20071128 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SHOHAM JOSHUA CENTRAL INDEX KEY: 0001552205 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-55127 FILM NUMBER: 162064151 MAIL ADDRESS: STREET 1: 35 ASUTA ST CITY: EVEN-YEHUDA STATE: L3 ZIP: 40500 4 1 shoham-form4_122016.xml OWNERSHIP DOCUMENT X0306 4 2016-12-20 0 0001419582 BLUE SPHERE CORP. BLSP 0001552205 SHOHAM JOSHUA 301 MCCULLOUGH DRIVE, 4TH FLOOR CHARLOTTE NC 28262 1 0 0 1 Chairman of the Board Common Stock, par vlaue $0.001 per share 2016-12-20 4 A 0 850000 A 3834001 D The 850,000 shares of Common Stock acquired by the reporting person represent 850,000 shares issuable pursuant to Mr. Shoham's Advisory Agreement with Blue Sphere Corporation, dated November 15, 2015, which vested on the one-year anniversary. Mr. Shoham received a stock award pursuant to the Company's 2014 Incentive Plan on February 24, 2015 for 3,500,000 shares of Common Stock, which vests in quarterly installments. As of the date of this report, 1,500,000 of such shares have vested and been issued, 1,312,500 shares have vested but have not yet been issued, and 729,167 shares remain to be vested. The 2,041,667 shares that have not yet vested and/or been issued are not included in the number of securities beneficially owned in Table I, Column 5 of this report. /s/ Joshua Shoham 2016-12-21