SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person*
Backenroth Samuel

(Last) (First) (Middle)
C/O VASCULAR BIOGENICS LTD.
8 HASATAT ST

(Street)
MODI'IN, L3 7178106

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
01/01/2023
3. Issuer Name and Ticker or Trading Symbol
Vascular Biogenics Ltd. [ VBLT ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Chief Financial Officer
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Restricted Stock Units (1) (1) Ordinary Shares 700,000 (1) D
Stock Option (Right to Buy) (2) 10/04/2041 Ordinary Shares 307,500 $2.22 D
Stock Option (Right to Buy) (3) 12/07/2041 Ordinary Shares 79,406 $2.31 D
Stock Option (Right to Buy) (4) 01/02/2042 Ordinary Shares 52,937 $2.12 D
Explanation of Responses:
1. Represents restricted stock units ("RSUs") granted under the Issuer's Employee Share Ownership and Option Plan (2014) (the "2014 Plan"). Each RSU represents a contingent right to receive one Ordinary Share, par value NIS 0.01, with an exercise price of NIS 0.01, has no expiration date and vests as follows: 75% of the RSUs shall vest on March 31, 2023, with the remaining 25% vesting on August 9, 2024.
2. These options were granted on 10/04/21 under the 2014 Plan and vest over four years commencing on the grant date such that 25% vest on the first anniversary of the date of grant and quarterly thereafter for three years such that they are vested in full on the four-year anniversary of the grant date.
3. These options were granted on 12/07/21 under the 2014 Plan and vest over four years commencing on the grant date such that 25% vest on the first anniversary of the date of grant and quarterly thereafter for three years such that they are vested in full on the four-year anniversary of the grant date.
4. These options were granted on 01/02/2022 under the 2014 Plan and vest over three years commencing on the grant date such that 1/3 vest on the first anniversary of the date of grant and then quarterly thereafter for two years, such that they are vested in full on the three-year anniversary of the grant date.
Remarks:
Exhibit 24 - Power of Attorney
/s/ Samuel Backenroth 01/03/2023
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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