0001493152-17-012289.txt : 20171101 0001493152-17-012289.hdr.sgml : 20171101 20171101183700 ACCESSION NUMBER: 0001493152-17-012289 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20171030 FILED AS OF DATE: 20171101 DATE AS OF CHANGE: 20171101 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Betz Randal R CENTRAL INDEX KEY: 0001629386 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36763 FILM NUMBER: 171170227 MAIL ADDRESS: STREET 1: 507 30TH ST CITY: OCEAN CITY STATE: NJ ZIP: 08226 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Medovex Corp. CENTRAL INDEX KEY: 0001591165 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 463312262 FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 3060 ROYAL BLVD STREET 2: SUITE 150 CITY: ALPHARETTA STATE: GA ZIP: 30022 BUSINESS PHONE: 844-633-6839 MAIL ADDRESS: STREET 1: 3060 ROYAL BLVD STREET 2: SUITE 150 CITY: ALPHARETTA STATE: GA ZIP: 30022 FORMER COMPANY: FORMER CONFORMED NAME: SpineZ DATE OF NAME CHANGE: 20131105 4 1 form4.xml X0306 4 2017-10-30 0 0001591165 Medovex Corp. MDVX 0001629386 Betz Randal R 3060 ROYAL BLVD, SUITE 150 ALPHARETTA GA 30022 1 0 0 0 Common Stock 2017-10-30 4 A 0 12821 1.17 A 164837 D The Reporting Person was granted 12,821 shares of common stock in lieu of cash fees that were due to the Reporting Person as of September 30, 2017 for his board services. The number of shares issued is based on the accrued but unpaid director fees owed to the Reporting Person during the nine months ended 2017, divided by the average closing price of the Issuer's common stock during the nine months ended 2017. /s/ Randal R. Betz 2017-11-01