0001493152-20-020846.txt : 20201109 0001493152-20-020846.hdr.sgml : 20201109 20201109171513 ACCESSION NUMBER: 0001493152-20-020846 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20201105 FILED AS OF DATE: 20201109 DATE AS OF CHANGE: 20201109 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Laxminarain Prattipati CENTRAL INDEX KEY: 0001725204 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-19871 FILM NUMBER: 201298735 MAIL ADDRESS: STREET 1: 3 HEWINS FARM ROAD CITY: WELLESLEY STATE: MA ZIP: 02481 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Microbot Medical Inc. CENTRAL INDEX KEY: 0000883975 STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836] IRS NUMBER: 943078125 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 25 RECREATION PARK DR SUITE 108 CITY: HINGHAM STATE: MA ZIP: 02043 BUSINESS PHONE: 908-938-5561 MAIL ADDRESS: STREET 1: 25 RECREATION PARK DR SUITE 108 CITY: HINGHAM STATE: MA ZIP: 02043 FORMER COMPANY: FORMER CONFORMED NAME: STEMCELLS INC DATE OF NAME CHANGE: 20000524 FORMER COMPANY: FORMER CONFORMED NAME: CYTOTHERAPEUTICS INC/DE DATE OF NAME CHANGE: 19930328 4 1 ownership.xml X0306 4 2020-11-05 0 0000883975 Microbot Medical Inc. MBOT 0001725204 Laxminarain Prattipati C/O MICROBOT MEDICAL INC. 25 RECREATION PARK DRIVE, UNIT 108 HINGHAM MA 02043 1 0 0 0 Stock Option (Right to Buy) 7.22 2020-11-05 4 A 0 2771 0 A 2030-11-05 Common Stock, par value $0.01 per share 2771 2771 D The options vest as follows and in accordance with the terms of the Issuer's 2017 Equity Incentive Plan: (a) on May 5, 2021, the option shall vest and shall become exercisable with respect to 25% of the common stock; and (b) on a quarterly basis over the next 30 months, the option shall equally vest and become exercisable with respect to the remaining 75% of the common stock. /s/ Prattipati Laxminarain 2020-11-09