0001387131-17-000013.txt : 20170103
0001387131-17-000013.hdr.sgml : 20170103
20170103163556
ACCESSION NUMBER: 0001387131-17-000013
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20161230
FILED AS OF DATE: 20170103
DATE AS OF CHANGE: 20170103
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: AMITZUR ELROY
CENTRAL INDEX KEY: 0001528561
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-55127
FILM NUMBER: 17502217
MAIL ADDRESS:
STREET 1: KASTIELSICA #2
CITY: BRATISLAVA
STATE: 2B
ZIP: 82105
4
1
amitzur-form4_123016.xml
OWNERSHIP DOCUMENT
X0306
4
2016-12-30
0
0001419582
BLUE SPHERE CORP.
BLSP
0001528561
AMITZUR ELROY
301 MCCULLOUGH DRIVE, 4TH FLOOR
CHARLOTTE
NC
28262
0
1
0
0
Executive Vice President
Common Stock, par value $0.001 per share
2016-12-30
4
A
0
850000
A
4088514
I
By Renewable Energy Management Services
Common Stock, par value $0.001 per share
2016-12-30
4
A
0
1750000
A
5838514
I
By Renewable Energy Management Services
Stock Award
2016-12-30
4
D
0
1750000
A
Common Stock, par value, $0.001 per share
1750000
291667
I
By Renewable Energy Management Services
The 850,000 shares of Common Stock acquired by the reporting person represent 850,000 shares which vested on the one-year anniversary of and became issuable pursuant to the Service Agreement, dated November 15, 2015, between Mr. Amitzur, JLS Advanced Investment Holdings Ltd. ("JLS") and Blue Sphere Corporation, as modified by Addendum No. 1 to Service Agreement, dated December 29, 2016, between Mr. Amitzur, JLS, Renewable Energy Management Services and Blue Sphere Corporation. Pursuant to such Addendum No. 1, the right to acquire shares of Common Stock under the Service Agreement was transferred to Renewable Energy Management Services.
The 1,750,000 shares of Common Stock acquired by the reporting person represent 1,750,000 shares awarded pursuant to a stock award under the Issuer's Global Share and Options Incentive Enhancement Plan (2014) (the "2014 Incentive Plan") which vested during 2016. The stock award under the 2014 Incentive Plan was granted on February 24, 2015 for 3,500,000 shares of Common Stock and vests in quarterly installments. As of the date of this report, 3,208,333 of such shares have been issued and 291,667 of such shares have not vested and have not been issued. The 291,667 shares that have not yet vested and not been issued are not included in the number of securities beneficially owned in Table I, Column 5 of this report.
The securities acquired in Table I, Column 4 and reported in Table II, Column 9 of this report are beneficially owned by Renewable Energy Management Services, a wholly owned subsidiary of RR Water Projects Ltd., which is owned and controlled by Mr. Amitzur and his wife. Therefore, Mr. Amitzur is deemed to have indirect beneficial ownership of such securities. Securities previously reported as beneficially owned by JLS under Table II, Column 9 of this report were issued to Renewable Energy Management Services.
The stock award under the 2014 Incentive Plan was granted on February 24, 2015 for 3,500,000 shares of Common Stock and vests in quarterly installments. As of the date of this report, 3,208,333 of such shares have been issued and 291,667 of such shares have not vested and have not been issued.
/s/ Elroy Amitzur
2016-12-30