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