0001493152-21-019251.txt : 20210810
0001493152-21-019251.hdr.sgml : 20210810
20210810214438
ACCESSION NUMBER: 0001493152-21-019251
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210805
FILED AS OF DATE: 20210810
DATE AS OF CHANGE: 20210810
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Singh Gurdev Dave
CENTRAL INDEX KEY: 0001835538
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39796
FILM NUMBER: 211161757
MAIL ADDRESS:
STREET 1: 9137 RIDGELINE BOULEVARD, SUITE 135
CITY: HIGHLANDS RANCH
STATE: CO
ZIP: 80129
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Vivos Therapeutics, Inc.
CENTRAL INDEX KEY: 0001716166
STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841]
IRS NUMBER: 813224056
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 9137 RIDGELINE BOULEVARD
STREET 2: SUITE 135
CITY: HIGHLANDS RANCH
STATE: CO
ZIP: 80129
BUSINESS PHONE: (866)908-4867
MAIL ADDRESS:
STREET 1: 9137 RIDGELINE BOULEVARD
STREET 2: SUITE 135
CITY: HIGHLANDS RANCH
STATE: CO
ZIP: 80129
FORMER COMPANY:
FORMER CONFORMED NAME: Vivos BioTechnologies, Inc.
DATE OF NAME CHANGE: 20170901
4
1
ownership.xml
X0306
4
2021-08-05
0
0001716166
Vivos Therapeutics, Inc.
VVOS
0001835538
Singh Gurdev Dave
9137 S. RIDGELINE BLVD, SUITE 135
HIGHLANDS RANCH
CO
80129
1
1
1
0
Chief Medical Officer
Common Stock
3219705
I
See footnote
Stock Option (Right to Buy)
2.72
2021-08-05
4
A
0
30000
2.72
A
2026-08-05
Common Stock
46667
46667
D
Shares held by Himmat LP, of which reporting person is a member and manager.
30,000 stock options granted on August 5, 2021. One-half vested immediately and one-eighth vests quarterly every three months through August 5, 2022.
/s/ Brad Amman as attorney-in-fact for G.Dave Singh
2021-08-10