0001493152-17-012292.txt : 20171101 0001493152-17-012292.hdr.sgml : 20171101 20171101183846 ACCESSION NUMBER: 0001493152-17-012292 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: Crowne Jesse CENTRAL INDEX KEY: 0001715501 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36763 FILM NUMBER: 171170231 MAIL ADDRESS: STREET 1: 1950 AIRPORT ROAD, SUITE A CITY: ATLANTA STATE: GA ZIP: 30341 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 0001715501 Crowne Jesse 3060 ROYAL BLVD, SUITE 150 ALPHARETTA GA 30022 1 0 0 0 Common Stock 2017-10-30 4 A 0 2137 1.17 A 169100 D Common Stock 2017-10-30 4 A 0 31240 1.08 A 200340 D The Reporting Person was granted 2,137 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. The Reporting Person was granted a restricted stock award of 125,000 shares (the "RSA") pursuant to the Issuer's 2013 Stock Option Incentive Plan. The shares fully vest over a two year period as follows: 25% on the grant date; 25% on the first anniversary of the grant; and 50% on the second anniversary of the grant. The number of shares issued represents the vested portion of the RSA. /s/ Jesse Crowne 2017-11-01