0001493152-23-039527.txt : 20231106 0001493152-23-039527.hdr.sgml : 20231106 20231106161518 ACCESSION NUMBER: 0001493152-23-039527 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20231102 FILED AS OF DATE: 20231106 DATE AS OF CHANGE: 20231106 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Madden Martin J. CENTRAL INDEX KEY: 0001696864 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-19871 FILM NUMBER: 231380132 MAIL ADDRESS: STREET 1: C/O MICROBOT MEDICAL INC. STREET 2: 175 DERBY STREET 27/1 CITY: HINGHAM STATE: MA ZIP: 02043 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Microbot Medical Inc. CENTRAL INDEX KEY: 0000883975 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] 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 X0508 4 2023-11-02 0 0000883975 Microbot Medical Inc. MBOT 0001696864 Madden Martin J. C/O MICROBOT MEDICAL INC. 288 GROVE STREET, SUITE 388 BRAINTREE MA 02184 1 0 0 0 0 Stock Option (Right to Buy) 1.28 2023-11-02 4 A 0 74218 0.0 A 2033-11-02 Common Stock, par value $0.01 per share 74218 74218 D The options vest as follows and in accordance with the terms of the Issuer's 2020 Omnibus Performance Award Plan, as amended: (a) on May 2, 2024, 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/ Martin Madden 2023-11-06