0001104659-24-032409.txt : 20240308 0001104659-24-032409.hdr.sgml : 20240308 20240308161938 ACCESSION NUMBER: 0001104659-24-032409 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240306 FILED AS OF DATE: 20240308 DATE AS OF CHANGE: 20240308 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Raphael Erez CENTRAL INDEX KEY: 0001668046 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37704 FILM NUMBER: 24734642 MAIL ADDRESS: STREET 1: 9 HALAMISH STREET STREET 2: CAESAREA INDUSTRIAL PARK CITY: CAESAREA STATE: L3 ZIP: 38900 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: DarioHealth Corp. CENTRAL INDEX KEY: 0001533998 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] ORGANIZATION NAME: 08 Industrial Applications and Services IRS NUMBER: 452973162 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 322 W 57TH ST. #33B CITY: NEW YORK STATE: NY ZIP: 10019 BUSINESS PHONE: 972-4-770-6377 MAIL ADDRESS: STREET 1: 322 W 57TH ST. #33B CITY: NEW YORK STATE: NY ZIP: 10019 FORMER COMPANY: FORMER CONFORMED NAME: LabStyle Innovations Corp. DATE OF NAME CHANGE: 20111101 4 1 tm248350-4_4seq1.xml OWNERSHIP DOCUMENT X0508 4 2024-03-06 0 0001533998 DarioHealth Corp. DRIO 0001668046 Raphael Erez 322 W 57TH ST, #33B NEW YORK NY 10019 1 1 0 0 Chief Executive Officer 0 Common Stock 2024-03-06 4 A 0 800000 0 A 1912059 D Common Stock 37876 I By Dicilyon Consulting and Investment Ltd. The shares vest as follows: (i) 50% vest on the grant date and (ii) 50% vest in quarterly instalments on the last day of each calendar quarter commencing March 31, 2024 for a two year period. The amount shown represents the beneficial ownership of the issuer's securities held by Dicilyon Consulting and Investment Ltd. which may be deemed to be attributable to Mr. Raphael because Mr. Raphael possesses voting and dispositive power over the securities held by Dicilyon Consulting and Investment Ltd. by virtue of a proxy. Mr. Raphael disclaims beneficial ownership of the securities set forth herein. /s/ Erez Raphael 2024-03-08