0001493152-21-008150.txt : 20210407 0001493152-21-008150.hdr.sgml : 20210407 20210407094101 ACCESSION NUMBER: 0001493152-21-008150 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210407 FILED AS OF DATE: 20210407 DATE AS OF CHANGE: 20210407 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Sharon Simon CENTRAL INDEX KEY: 0001851272 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 000-19871 FILM NUMBER: 21810944 MAIL ADDRESS: STREET 1: 8 HAMADA STREET CITY: ZICHRON YAACOV STATE: L3 ZIP: 3090708 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 3 1 ownership.xml X0206 3 2021-04-07 0 0000883975 Microbot Medical Inc. MBOT 0001851272 Sharon Simon C/O MICROBOT MEDICAL INC. 25 RECREATION PARK DRIVE, UNIT 108 HINGHAM, MA 02043 0 1 0 0 General Manager & CTO Stock Option (Right to Buy) 9.00 2028-08-13 Common Stock, par value $0.01 per share 10000 D Stock Option (Right to Buy) 5.95 2029-08-12 Common Stock, par value $0.01 per share 14170 D The option vests as follows and in accordance with the terms of the Issuer's 2017 Equity Incentive Plan: (a) on February 13, 2019, the option vested and became 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. The option vests as follows and in accordance with the terms of the Issuer's 2017 Equity Incentive Plan: (a) on February 12, 2020, the option vested and became 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/ Simon Sharon 2021-04-07