0001209191-21-057562.txt : 20210924 0001209191-21-057562.hdr.sgml : 20210924 20210924151855 ACCESSION NUMBER: 0001209191-21-057562 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210923 FILED AS OF DATE: 20210924 DATE AS OF CHANGE: 20210924 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Polinsky David CENTRAL INDEX KEY: 0001726896 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38411 FILM NUMBER: 211277116 MAIL ADDRESS: STREET 1: 90 BOOTH AVENUE CITY: ENGLEWOOD STATE: NJ ZIP: 07631 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Rafael Holdings, Inc. CENTRAL INDEX KEY: 0001713863 STANDARD INDUSTRIAL CLASSIFICATION: REAL ESTATE [6500] IRS NUMBER: 822296593 STATE OF INCORPORATION: DE FISCAL YEAR END: 0731 BUSINESS ADDRESS: STREET 1: 520 BROAD STREET CITY: NEWARK STATE: NJ ZIP: 07120 BUSINESS PHONE: 212-658-1450 MAIL ADDRESS: STREET 1: 520 BROAD STREET CITY: NEWARK STATE: NJ ZIP: 07120 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2021-09-23 1 0001713863 Rafael Holdings, Inc. RFL 0001726896 Polinsky David C/O RAFAEL HOLDINGS, INC. 520 BROAD ST NEWARK NJ 07102 0 1 0 0 Former Chief Financial Officer Class B Common Stock, par value $.01 per share 2021-09-23 4 F 0 571 35.77 D 17429 D Represents shares withheld by the Issuer for tax purposes upon vesting of restricted stock. Consists of 12,430 vested shares of Class B Common Stock and 4,999 unvested restricted shares of Class B Common Stock that vest as follows: 3,333 on September 23, 2022 and 1,666 on September 23, 2023. Joyce J. Mason, by Power of Attorney 2021-09-24