0001178913-17-001784.txt : 20170609
0001178913-17-001784.hdr.sgml : 20170609
20170609112235
ACCESSION NUMBER: 0001178913-17-001784
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20170601
FILED AS OF DATE: 20170609
DATE AS OF CHANGE: 20170609
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Integrity Applications, Inc.
CENTRAL INDEX KEY: 0001506983
STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841]
IRS NUMBER: 980668934
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 19 HA'YAHALOMIM ST
STREET 2: P.O. BOX 12163
CITY: ASHDOD
STATE: L3
ZIP: L3 7760049
BUSINESS PHONE: 972 (8) 675-7878
MAIL ADDRESS:
STREET 1: 19 HA'YAHALOMIM ST
STREET 2: P.O. BOX 12163
CITY: ASHDOD
STATE: L3
ZIP: L3 7760049
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Hauck Michael
CENTRAL INDEX KEY: 0001708854
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-54785
FILM NUMBER: 17901899
MAIL ADDRESS:
STREET 1: 19 HA'YAHALOMIM ST., P.O. BOX 12163
STREET 2: C/O INTEGRITY APPLICATIONS, INC.
CITY: ASHDOD
STATE: L3
ZIP: 7760049
4
1
zk1720120.xml
OWNERSHIP DOCUMENT
X0306
4
2017-06-01
0
0001506983
Integrity Applications, Inc.
IGAP
0001708854
Hauck Michael
19 HA'YAHALOMIM ST., P.O. BOX 12163
C/O INTEGRITY APPLICATIONS, INC.
ASHDOD
L3
7760049
ISRAEL
1
0
0
0
Option (Right to Buy)
4.50
2017-06-01
4
A
0
14894
0
A
2027-06-01
Common Stock, par value $0.001 per share
14894
14894
D
Restricted Stock Units
0
2017-06-01
4
A
0
22727
0
A
2018-06-01
Common Stock, par value $0.001 per share
22727
22727
D
The options will vest in equal monthly installments over a one year period commencing on June 1, 2017.
The restricted stock units are scheduled to vest on June 1, 2018, assuming continued service as a director through and on such date.
After June 1, 2018, the common stock underlying the restricted stock units may be issued on such date as the reporting person elects or upon termination of their service with the Issuer.
/s/ Michael Hauck
2017-06-09